Provider Demographics
NPI:1881838886
Name:TUGGLE, JAMES ALEXANDER (LAC)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:ALEXANDER
Last Name:TUGGLE
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:MR
Other - First Name:ALEX
Other - Middle Name:
Other - Last Name:TUGGLE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LAC
Mailing Address - Street 1:1419 GRAND ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:ALAMEDA
Mailing Address - State:CA
Mailing Address - Zip Code:94501-2569
Mailing Address - Country:US
Mailing Address - Phone:510-926-1902
Mailing Address - Fax:
Practice Address - Street 1:1419 GRAND ST
Practice Address - Street 2:SUITE 101
Practice Address - City:ALAMEDA
Practice Address - State:CA
Practice Address - Zip Code:94501-2569
Practice Address - Country:US
Practice Address - Phone:510-926-1902
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-22
Last Update Date:2014-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC 12494171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist