Provider Demographics
NPI:1639495567
Name:KALISHER, CHERIE A (LAC)
Entity Type:Individual
Prefix:
First Name:CHERIE
Middle Name:A
Last Name:KALISHER
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 1:3631 MCLAUGHLIN AVE
Mailing Address - Street 2:APT 4
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90066-3346
Mailing Address - Country:US
Mailing Address - Phone:310-801-8286
Mailing Address - Fax:
Practice Address - Street 1:3631 MCLAUGHLIN AVE
Practice Address - Street 2:APT 4
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90066-3346
Practice Address - Country:US
Practice Address - Phone:310-801-8286
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-16
Last Update Date:2010-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC 13518171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist