Provider Demographics
NPI:1750791430
Name:ANTOUN, CINDY (LAC)
Entity type:Individual
Prefix:
First Name:CINDY
Middle Name:
Last Name:ANTOUN
Suffix:
Gender:
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19231 VICTORY BLVD STE 150
Mailing Address - Street 2:
Mailing Address - City:RESEDA
Mailing Address - State:CA
Mailing Address - Zip Code:91335-6315
Mailing Address - Country:US
Mailing Address - Phone:818-492-9383
Mailing Address - Fax:
Practice Address - Street 1:19231 VICTORY BLVD STE 150
Practice Address - Street 2:
Practice Address - City:RESEDA
Practice Address - State:CA
Practice Address - Zip Code:91335-6315
Practice Address - Country:US
Practice Address - Phone:818-492-9383
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-02
Last Update Date:2025-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC 15991171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist