Provider Demographics
NPI:1659536746
Name:KAO, LAN KAREN (DACM, LAC)
Entity Type:Individual
Prefix:DR
First Name:LAN
Middle Name:KAREN
Last Name:KAO
Suffix:
Gender:F
Credentials:DACM, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8050 FAIRCHILD AVE
Mailing Address - Street 2:
Mailing Address - City:WINNETKA
Mailing Address - State:CA
Mailing Address - Zip Code:91306-2011
Mailing Address - Country:US
Mailing Address - Phone:310-889-4937
Mailing Address - Fax:
Practice Address - Street 1:1821 WILSHIRE BLVD STE 605
Practice Address - Street 2:
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90403-5674
Practice Address - Country:US
Practice Address - Phone:310-889-4937
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-28
Last Update Date:2020-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIACU-541171100000X
CAAC6644171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist