Provider Demographics
NPI:1609152891
Name:ARHIN, PREMA (LAC)
Entity Type:Individual
Prefix:
First Name:PREMA
Middle Name:
Last Name:ARHIN
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:614 GRAND AVE
Mailing Address - Street 2:SUITE # B AND C
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94610-3554
Mailing Address - Country:US
Mailing Address - Phone:510-286-8100
Mailing Address - Fax:
Practice Address - Street 1:614 GRAND AVE
Practice Address - Street 2:SUITE # B AND C
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94610-3554
Practice Address - Country:US
Practice Address - Phone:510-286-8100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-01
Last Update Date:2011-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC 14100171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist