Provider Demographics
NPI:1922166883
Name:KUROTANI, KEI (LAC, PHD)
Entity Type:Individual
Prefix:DR
First Name:KEI
Middle Name:
Last Name:KUROTANI
Suffix:
Gender:M
Credentials:LAC, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 ROLLINS RD
Mailing Address - Street 2:SUITE 109
Mailing Address - City:MILLBRAE
Mailing Address - State:CA
Mailing Address - Zip Code:94030-3130
Mailing Address - Country:US
Mailing Address - Phone:650-697-3123
Mailing Address - Fax:650-697-3077
Practice Address - Street 1:10 ROLLINS RD
Practice Address - Street 2:SUITE 109
Practice Address - City:MILLBRAE
Practice Address - State:CA
Practice Address - Zip Code:94030-3130
Practice Address - Country:US
Practice Address - Phone:650-697-3123
Practice Address - Fax:650-697-3077
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC7521171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist