Provider Demographics
NPI:1215188164
Name:SCHWARTZ, DANA ANN (LAC)
Entity Type:Individual
Prefix:
First Name:DANA
Middle Name:ANN
Last Name:SCHWARTZ
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 1:2801 OCEAN PARK BLVD
Mailing Address - Street 2:PO BOX 381
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90405-2905
Mailing Address - Country:US
Mailing Address - Phone:213-925-2026
Mailing Address - Fax:
Practice Address - Street 1:1509 ABBOT KINNEY BLVD
Practice Address - Street 2:B
Practice Address - City:VENICE
Practice Address - State:CA
Practice Address - Zip Code:90291-3742
Practice Address - Country:US
Practice Address - Phone:310-396-8928
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-08
Last Update Date:2008-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA12035 AC171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist