Provider Demographics
NPI:1346859113
Name:HUNT, JAN (LAC)
Entity Type:Individual
Prefix:DR
First Name:JAN
Middle Name:
Last Name:HUNT
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 1:3022 DANALDA DR
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90064-4626
Mailing Address - Country:US
Mailing Address - Phone:310-838-1602
Mailing Address - Fax:310-838-1604
Practice Address - Street 1:3022 DANALDA DR
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90064-4626
Practice Address - Country:US
Practice Address - Phone:310-838-1602
Practice Address - Fax:310-838-1604
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-28
Last Update Date:2020-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA8797171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist