Provider Demographics
NPI:1023136603
Name:BRANTMAN, ANNA (L AC)
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:
Last Name:BRANTMAN
Suffix:
Gender:F
Credentials:L AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:8635 W 3RD ST STE 1180W
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90048-6114
Mailing Address - Country:US
Mailing Address - Phone:310-423-8664
Mailing Address - Fax:310-460-0099
Practice Address - Street 1:8635 W 3RD ST STE 1180W
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90048-6114
Practice Address - Country:US
Practice Address - Phone:310-423-8664
Practice Address - Fax:310-460-0099
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-26
Last Update Date:2024-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC 9273171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist