Provider Demographics
NPI:1417257445
Name:LAPKIN, TYLER EDWARD (LAC)
Entity Type:Individual
Prefix:MR
First Name:TYLER
Middle Name:EDWARD
Last Name:LAPKIN
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:PO BOX 1918
Mailing Address - Street 2:
Mailing Address - City:TAHOE CITY
Mailing Address - State:CA
Mailing Address - Zip Code:96145-1918
Mailing Address - Country:US
Mailing Address - Phone:530-414-0394
Mailing Address - Fax:
Practice Address - Street 1:925 NORTH LAKE BOULEVARD
Practice Address - Street 2:B-207
Practice Address - City:TAHOE CITY
Practice Address - State:CA
Practice Address - Zip Code:96145
Practice Address - Country:US
Practice Address - Phone:530-414-0394
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-25
Last Update Date:2011-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC 13746171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist