Provider Demographics
NPI:1841211679
Name:KWAN, SANTINA L (LAC)
Entity type:Individual
Prefix:DR
First Name:SANTINA
Middle Name:L
Last Name:KWAN
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:18740 VENTURA BLVD
Mailing Address - Street 2:SUITE 204
Mailing Address - City:TARZANA
Mailing Address - State:CA
Mailing Address - Zip Code:91356-3366
Mailing Address - Country:US
Mailing Address - Phone:818-708-1698
Mailing Address - Fax:866-423-6093
Practice Address - Street 1:18740 VENTURA BLVD
Practice Address - Street 2:SUITE 204
Practice Address - City:TARZANA
Practice Address - State:CA
Practice Address - Zip Code:91356-3366
Practice Address - Country:US
Practice Address - Phone:818-708-1698
Practice Address - Fax:866-423-6093
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC3071171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist