Provider Demographics
NPI:1255663951
Name:ANDINO, MARIA (LAC)
Entity Type:Individual
Prefix:MS
First Name:MARIA
Middle Name:
Last Name:ANDINO
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:4821 LANKERSHIM BLVD
Mailing Address - Street 2:SUITE F377
Mailing Address - City:NORTH HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:91601-4538
Mailing Address - Country:US
Mailing Address - Phone:818-275-2444
Mailing Address - Fax:
Practice Address - Street 1:4789 VINELAND AVE
Practice Address - Street 2:SUITE 204
Practice Address - City:NORTH HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:91602-3518
Practice Address - Country:US
Practice Address - Phone:818-275-2444
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-04
Last Update Date:2013-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC14182171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist