Provider Demographics
NPI:1407115413
Name:SWEENEY, PATRICK (LAC)
Entity Type:Individual
Prefix:
First Name:PATRICK
Middle Name:
Last Name:SWEENEY
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1131 PACIFIC AVE
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94133-4211
Mailing Address - Country:US
Mailing Address - Phone:415-928-2214
Mailing Address - Fax:415-928-2214
Practice Address - Street 1:1131 PACIFIC AVE
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94133-4211
Practice Address - Country:US
Practice Address - Phone:415-928-2214
Practice Address - Fax:415-928-2214
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-10
Last Update Date:2012-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA14404171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist