Provider Demographics
NPI:1194844548
Name:KHUONG, NHAN-ESTEBAN VILLARREAL (LAC)
Entity Type:Individual
Prefix:MR
First Name:NHAN-ESTEBAN
Middle Name:VILLARREAL
Last Name:KHUONG
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 1:711 E WALNUT ST
Mailing Address - Street 2:SUITE 305
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91101-1676
Mailing Address - Country:US
Mailing Address - Phone:310-365-8155
Mailing Address - Fax:
Practice Address - Street 1:711 E WALNUT ST
Practice Address - Street 2:SUITE 305
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91101-1676
Practice Address - Country:US
Practice Address - Phone:310-365-8155
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC11133171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist