Provider Demographics
NPI:1255751905
Name:LOOK, ARCHIBALD (ATC)
Entity type:Individual
Prefix:
First Name:ARCHIBALD
Middle Name:
Last Name:LOOK
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:KEN
Other - Middle Name:
Other - Last Name:LOOK
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:415 ACALANES DR APT 25
Mailing Address - Street 2:
Mailing Address - City:SUNNYVALE
Mailing Address - State:CA
Mailing Address - Zip Code:94086-7135
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:415 ACALANES DR APT 25
Practice Address - Street 2:
Practice Address - City:SUNNYVALE
Practice Address - State:CA
Practice Address - Zip Code:94086-7135
Practice Address - Country:US
Practice Address - Phone:805-637-2197
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-21
Last Update Date:2014-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
2255A2300X
CA2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer