Provider Demographics
NPI:1417633025
Name:KARAMOL, LUKE (CMT, RYT, AHC)
Entity Type:Individual
Prefix:
First Name:LUKE
Middle Name:
Last Name:KARAMOL
Suffix:
Gender:M
Credentials:CMT, RYT, AHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3770 PARK BOULEVARD WAY APT 301
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94610-2802
Mailing Address - Country:US
Mailing Address - Phone:510-495-7939
Mailing Address - Fax:
Practice Address - Street 1:3947 OPAL ST
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94609-2626
Practice Address - Country:US
Practice Address - Phone:510-495-7939
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-27
Last Update Date:2023-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA23955225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist