Provider Demographics
NPI:1326346230
Name:HILL, ALICIA (LAC)
Entity Type:Individual
Prefix:
First Name:ALICIA
Middle Name:
Last Name:HILL
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 1:308 ANDERSON ST
Mailing Address - Street 2:
Mailing Address - City:MANHATTAN BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90266-6612
Mailing Address - Country:US
Mailing Address - Phone:310-372-7585
Mailing Address - Fax:
Practice Address - Street 1:308 ANDERSON ST
Practice Address - Street 2:
Practice Address - City:MANHATTAN BEACH
Practice Address - State:CA
Practice Address - Zip Code:90266-6612
Practice Address - Country:US
Practice Address - Phone:310-372-7585
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-02
Last Update Date:2011-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC13197171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist