Provider Demographics
NPI:1043420904
Name:ARMENTEROS, RICHARD (LAC, OMD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:
Last Name:ARMENTEROS
Suffix:
Gender:M
Credentials:LAC, OMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8655 FRESNO CIR UNIT 501C
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92646-5732
Mailing Address - Country:US
Mailing Address - Phone:714-580-8399
Mailing Address - Fax:
Practice Address - Street 1:8655 FRESNO CIR UNIT 501C
Practice Address - Street 2:
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92646-5732
Practice Address - Country:US
Practice Address - Phone:714-580-8399
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-22
Last Update Date:2011-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC1417171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist