Provider Demographics
NPI:1457027476
Name:ALEKSEEV, IGOR (LAC, DACM)
Entity Type:Individual
Prefix:
First Name:IGOR
Middle Name:
Last Name:ALEKSEEV
Suffix:
Gender:M
Credentials:LAC, DACM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1222 GENEVA AVE
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94112-3824
Mailing Address - Country:US
Mailing Address - Phone:925-890-4350
Mailing Address - Fax:
Practice Address - Street 1:1222 GENEVA AVE
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94112-3824
Practice Address - Country:US
Practice Address - Phone:925-890-4350
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-19
Last Update Date:2021-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA18847171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist