Provider Demographics
NPI:1922249788
Name:HUTTER, ANDREA SALZMAN (LAC)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:SALZMAN
Last Name:HUTTER
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:ANDREA
Other - Middle Name:JESSICA
Other - Last Name:SALZMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:410 N FLORES ST
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90048-2612
Mailing Address - Country:US
Mailing Address - Phone:323-658-8328
Mailing Address - Fax:
Practice Address - Street 1:410 N FLORES ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90048-2612
Practice Address - Country:US
Practice Address - Phone:323-658-8328
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-09
Last Update Date:2009-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA13009171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist