Provider Demographics
NPI:1639280803
Name:HASKINS, CORRINNE M (LAC)
Entity Type:Individual
Prefix:
First Name:CORRINNE
Middle Name:M
Last Name:HASKINS
Suffix:
Gender:F
Credentials:LAC
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Mailing Address - Street 1:25550 HAWTHORNE BLVD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90505-6825
Mailing Address - Country:US
Mailing Address - Phone:310-373-4747
Mailing Address - Fax:310-373-9225
Practice Address - Street 1:25550 HAWTHORNE BLVD
Practice Address - Street 2:SUITE 300
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-6825
Practice Address - Country:US
Practice Address - Phone:310-373-4747
Practice Address - Fax:310-373-9225
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CA8660171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist