Provider Demographics
NPI:1134456239
Name:MYERS, ALMA WAYNE (LAC)
Entity type:Individual
Prefix:MR
First Name:ALMA
Middle Name:WAYNE
Last Name:MYERS
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6660 YARMOUTH AVE
Mailing Address - Street 2:
Mailing Address - City:RESEDA
Mailing Address - State:CA
Mailing Address - Zip Code:91335-5619
Mailing Address - Country:US
Mailing Address - Phone:310-210-8580
Mailing Address - Fax:
Practice Address - Street 1:6660 YARMOUTH AVE
Practice Address - Street 2:
Practice Address - City:RESEDA
Practice Address - State:CA
Practice Address - Zip Code:91335-5619
Practice Address - Country:US
Practice Address - Phone:310-210-8580
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-10
Last Update Date:2011-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA13391171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist