Provider Demographics
NPI:1225408586
Name:MORGAN, MERLE (LAC, DIP AC)
Entity Type:Individual
Prefix:
First Name:MERLE
Middle Name:
Last Name:MORGAN
Suffix:
Gender:F
Credentials:LAC, DIP AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12871 W. RUNWAY ROAD
Mailing Address - Street 2:UNIT 1
Mailing Address - City:PLAYA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:90094
Mailing Address - Country:US
Mailing Address - Phone:310-699-9616
Mailing Address - Fax:
Practice Address - Street 1:12871 W. RUNWAY RD
Practice Address - Street 2:UNIT 1
Practice Address - City:PLAYA VISTA
Practice Address - State:CA
Practice Address - Zip Code:90094
Practice Address - Country:US
Practice Address - Phone:310-699-9616
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-30
Last Update Date:2015-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC8782171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist