Provider Demographics
NPI:1437305216
Name:BINA, JACQUES N (LAC, MTOM)
Entity Type:Individual
Prefix:MR
First Name:JACQUES
Middle Name:N
Last Name:BINA
Suffix:
Gender:M
Credentials:LAC, MTOM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4570 VAN NUYS BLVD
Mailing Address - Street 2:PMB 157
Mailing Address - City:SHERMAN OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91403-2913
Mailing Address - Country:US
Mailing Address - Phone:818-342-8020
Mailing Address - Fax:
Practice Address - Street 1:12626 RIVERSIDE DR
Practice Address - Street 2:SUITE 511
Practice Address - City:NORTH HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:91607-3420
Practice Address - Country:US
Practice Address - Phone:818-342-8020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-13
Last Update Date:2008-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC4442171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist