Provider Demographics
NPI:1275973422
Name:BOONYAKIAT, NAPICH (DAOM, LAC)
Entity Type:Individual
Prefix:
First Name:NAPICH
Middle Name:
Last Name:BOONYAKIAT
Suffix:
Gender:F
Credentials:DAOM, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15126 POLLY AVE
Mailing Address - Street 2:
Mailing Address - City:LAWNDALE
Mailing Address - State:CA
Mailing Address - Zip Code:90260-2445
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1253 VINE ST STE 10
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90038-1662
Practice Address - Country:US
Practice Address - Phone:323-747-0987
Practice Address - Fax:323-395-9428
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-02
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC15437171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist