Provider Demographics
NPI:1841367018
Name:KUNG, MICHELLE ATANANTE (LAC, PHD)
Entity type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:ATANANTE
Last Name:KUNG
Suffix:
Gender:F
Credentials:LAC, PHD
Other - Prefix:DR
Other - First Name:MICHELLE
Other - Middle Name:ATANANTE
Other - Last Name:KUNG DE ABURTO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LAC, PHD
Mailing Address - Street 1:131 N EL MOLINO AVE
Mailing Address - Street 2:SUITE #230
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91101-1873
Mailing Address - Country:US
Mailing Address - Phone:626-289-9751
Mailing Address - Fax:626-583-4979
Practice Address - Street 1:131 N EL MOLINO AVE
Practice Address - Street 2:SUITE #230
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91101-1873
Practice Address - Country:US
Practice Address - Phone:626-289-9751
Practice Address - Fax:626-583-4979
Is Sole Proprietor?:No
Enumeration Date:2006-11-30
Last Update Date:2013-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC6994171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist