Provider Demographics
NPI:1851803852
Name:DY, ARTHUR (LAC)
Entity Type:Individual
Prefix:MR
First Name:ARTHUR
Middle Name:
Last Name:DY
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 EUGENIA AVE
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94110-5412
Mailing Address - Country:US
Mailing Address - Phone:415-285-6040
Mailing Address - Fax:415-285-6040
Practice Address - Street 1:10 EUGENIA AVE
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94110-5412
Practice Address - Country:US
Practice Address - Phone:415-285-6040
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-30
Last Update Date:2017-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA17781171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist