Provider Demographics
NPI:1164777637
Name:PERZIGIAN, ANDREW (LAC)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:
Last Name:PERZIGIAN
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3938 20TH ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94114-2907
Mailing Address - Country:US
Mailing Address - Phone:415-779-2915
Mailing Address - Fax:415-520-5941
Practice Address - Street 1:3938 20TH ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94114-2907
Practice Address - Country:US
Practice Address - Phone:415-779-2915
Practice Address - Fax:415-520-5941
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-19
Last Update Date:2012-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA14719171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist