Provider Demographics
NPI:1215019450
Name:DAI, MINDY MINHONG (LAC)
Entity Type:Individual
Prefix:MS
First Name:MINDY
Middle Name:MINHONG
Last Name:DAI
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:2031 W ALAMEDA AVE
Mailing Address - Street 2:SUITE 206
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91506-2958
Mailing Address - Country:US
Mailing Address - Phone:818-843-1558
Mailing Address - Fax:818-843-3385
Practice Address - Street 1:2031 W ALAMEDA AVE
Practice Address - Street 2:SUITE 206
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91506-2958
Practice Address - Country:US
Practice Address - Phone:818-843-1558
Practice Address - Fax:818-843-3385
Is Sole Proprietor?:No
Enumeration Date:2006-10-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC7755171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist