Provider Demographics
NPI:1083153746
Name:HORN, RUI (LAC)
Entity Type:Individual
Prefix:MRS
First Name:RUI
Middle Name:
Last Name:HORN
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:317 OAK ST STE A
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:94513-1186
Mailing Address - Country:US
Mailing Address - Phone:925-689-1221
Mailing Address - Fax:
Practice Address - Street 1:317 OAK ST STE A
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:CA
Practice Address - Zip Code:94513-1186
Practice Address - Country:US
Practice Address - Phone:925-689-1221
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-14
Last Update Date:2017-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC 17361171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist