Provider Demographics
NPI:1518106152
Name:TOYOFUKU, ALAN TAKAO (LAC)
Entity Type:Individual
Prefix:MR
First Name:ALAN
Middle Name:TAKAO
Last Name:TOYOFUKU
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 1:1680 N COAST HIGHWAY 101
Mailing Address - Street 2:UNIT #52
Mailing Address - City:ENCINITAS
Mailing Address - State:CA
Mailing Address - Zip Code:92024-1046
Mailing Address - Country:US
Mailing Address - Phone:760-525-0889
Mailing Address - Fax:
Practice Address - Street 1:1680 N COAST HIGHWAY 101
Practice Address - Street 2:UNIT #52
Practice Address - City:ENCINITAS
Practice Address - State:CA
Practice Address - Zip Code:92024-1046
Practice Address - Country:US
Practice Address - Phone:760-525-0889
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-04
Last Update Date:2009-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC 12290171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist