Provider Demographics
NPI:1154464840
Name:SOBEL, VIVIAN N (LAC DIPL AC)
Entity Type:Individual
Prefix:MS
First Name:VIVIAN
Middle Name:N
Last Name:SOBEL
Suffix:
Gender:F
Credentials:LAC DIPL AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29020 AGOURA RD
Mailing Address - Street 2:SUITE A8
Mailing Address - City:AGOURA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91301
Mailing Address - Country:US
Mailing Address - Phone:818-991-9561
Mailing Address - Fax:818-597-8668
Practice Address - Street 1:29020 AGOURA RD
Practice Address - Street 2:SUITE A8
Practice Address - City:AGOURA HILLS
Practice Address - State:CA
Practice Address - Zip Code:91301-2573
Practice Address - Country:US
Practice Address - Phone:818-991-9561
Practice Address - Fax:818-597-8668
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC 2953171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist