Provider Demographics
NPI:1770782864
Name:MUHL, BETHANY K (LAC)
Entity type:Individual
Prefix:
First Name:BETHANY
Middle Name:K
Last Name:MUHL
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:13315 W WASHINGTON BLVD
Mailing Address - Street 2:SUITE 304
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90066-5169
Mailing Address - Country:US
Mailing Address - Phone:310-367-1564
Mailing Address - Fax:
Practice Address - Street 1:13315 W WASHINGTON BLVD
Practice Address - Street 2:SUITE 304
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90066-5169
Practice Address - Country:US
Practice Address - Phone:310-367-1564
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-17
Last Update Date:2009-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC8884171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist