Provider Demographics
NPI:1841325156
Name:POSTOLOVA, LYUSYENA (LAC, DACM)
Entity type:Individual
Prefix:MS
First Name:LYUSYENA
Middle Name:
Last Name:POSTOLOVA
Suffix:
Gender:F
Credentials:LAC, DACM
Other - Prefix:MS
Other - First Name:LUCY
Other - Middle Name:
Other - Last Name:POSTOLOV
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LAC, DACM
Mailing Address - Street 1:1990 S BUNDY DR
Mailing Address - Street 2:SUITE 790
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90025-5240
Mailing Address - Country:US
Mailing Address - Phone:310-444-6212
Mailing Address - Fax:888-650-9839
Practice Address - Street 1:1990 S BUNDY DR
Practice Address - Street 2:SUITE 790
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90025-5240
Practice Address - Country:US
Practice Address - Phone:310-444-6212
Practice Address - Fax:888-650-9839
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-23
Last Update Date:2024-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC5202171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
954645328OtherTAX ID