Provider Demographics
NPI:1689707705
Name:ADAMEC, CHARLES G (LAC)
Entity Type:Individual
Prefix:MR
First Name:CHARLES
Middle Name:G
Last Name:ADAMEC
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2100 LAKESHORE AVE STE E
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94606-1188
Mailing Address - Country:US
Mailing Address - Phone:510-893-1577
Mailing Address - Fax:510-893-8907
Practice Address - Street 1:2100 LAKESHORE AVE STE E
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94606-1188
Practice Address - Country:US
Practice Address - Phone:510-893-1577
Practice Address - Fax:510-893-8907
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC10738171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist