Provider Demographics
NPI:1407019870
Name:CORZINE, STAN DEAN (L AC)
Entity Type:Individual
Prefix:MR
First Name:STAN
Middle Name:DEAN
Last Name:CORZINE
Suffix:
Gender:M
Credentials:L AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1155 11TH ST UNIT # 3
Mailing Address - Street 2:
Mailing Address - City:MANHATTAN BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90266-6054
Mailing Address - Country:US
Mailing Address - Phone:310-372-2064
Mailing Address - Fax:
Practice Address - Street 1:1155 11TH ST UNIT # 3
Practice Address - Street 2:
Practice Address - City:MANHATTAN BEACH
Practice Address - State:CA
Practice Address - Zip Code:90266-6054
Practice Address - Country:US
Practice Address - Phone:310-372-2064
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-07
Last Update Date:2010-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA7599171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist