Provider Demographics
NPI:1225294382
Name:CHERMAN, KEN N (LAC)
Entity Type:Individual
Prefix:
First Name:KEN
Middle Name:N
Last Name:CHERMAN
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:8121 VAN NUYS BLVD
Mailing Address - Street 2:#502
Mailing Address - City:PANORAMA CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91402-5105
Mailing Address - Country:US
Mailing Address - Phone:818-906-0808
Mailing Address - Fax:818-781-2293
Practice Address - Street 1:8121 VAN NUYS BLVD
Practice Address - Street 2:#502
Practice Address - City:PANORAMA CITY
Practice Address - State:CA
Practice Address - Zip Code:91402-5105
Practice Address - Country:US
Practice Address - Phone:818-906-0808
Practice Address - Fax:818-781-2293
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-29
Last Update Date:2008-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA4054171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist