Provider Demographics
NPI:1568870814
Name:VOYNIKOV, TENTCHO (LAC (MD, PHD))
Entity Type:Individual
Prefix:
First Name:TENTCHO
Middle Name:
Last Name:VOYNIKOV
Suffix:
Gender:M
Credentials:LAC (MD, PHD)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1385 7TH AVE
Mailing Address - Street 2:APT.29
Mailing Address - City:SANTA CRUZ
Mailing Address - State:CA
Mailing Address - Zip Code:95062-2748
Mailing Address - Country:US
Mailing Address - Phone:831-818-2440
Mailing Address - Fax:
Practice Address - Street 1:200 7TH AVE
Practice Address - Street 2:
Practice Address - City:SANTA CRUZ
Practice Address - State:CA
Practice Address - Zip Code:95062-4668
Practice Address - Country:US
Practice Address - Phone:831-476-9424
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-31
Last Update Date:2014-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC15941171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist