Provider Demographics
NPI:1922232669
Name:THORPE, ANDREA (LAC, MA TCM, DIP AC)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:
Last Name:THORPE
Suffix:
Gender:F
Credentials:LAC, MA TCM, DIP AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1131 WILSHIRE BLVD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90401-2061
Mailing Address - Country:US
Mailing Address - Phone:310-917-2200
Mailing Address - Fax:
Practice Address - Street 1:1131 WILSHIRE BLVD
Practice Address - Street 2:SUITE 300
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90401-2061
Practice Address - Country:US
Practice Address - Phone:310-917-2200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-05-10
Last Update Date:2009-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA11802171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist