Provider Demographics
NPI:1750596540
Name:MAGIN, SANDRA W (RN, LAC, OMD)
Entity type:Individual
Prefix:DR
First Name:SANDRA
Middle Name:W
Last Name:MAGIN
Suffix:
Gender:F
Credentials:RN, LAC, OMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1172 SAN PABLO AVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94706-2258
Mailing Address - Country:US
Mailing Address - Phone:510-525-3016
Mailing Address - Fax:510-525-3930
Practice Address - Street 1:1172 SAN PABLO AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94706-2258
Practice Address - Country:US
Practice Address - Phone:510-525-3016
Practice Address - Fax:510-525-3930
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC2344171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist