Provider Demographics
NPI:1073634648
Name:DORSETT, ROBERT JOHN (L AC, DIPLO ACUP)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:JOHN
Last Name:DORSETT
Suffix:
Gender:M
Credentials:L AC, DIPLO ACUP
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:2251 CLINTON AVE APT E
Mailing Address - Street 2:
Mailing Address - City:ALAMEDA
Mailing Address - State:CA
Mailing Address - Zip Code:94501-4965
Mailing Address - Country:US
Mailing Address - Phone:510-522-5263
Mailing Address - Fax:510-522-5263
Practice Address - Street 1:2245 SANTA CLARA AVE STE 218
Practice Address - Street 2:
Practice Address - City:ALAMEDA
Practice Address - State:CA
Practice Address - Zip Code:94501-4443
Practice Address - Country:US
Practice Address - Phone:510-817-8771
Practice Address - Fax:510-814-8772
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAAC3275171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist