Provider Demographics
NPI:1881948776
Name:FALKAN, SYRS (LAC)
Entity type:Individual
Prefix:
First Name:SYRS
Middle Name:
Last Name:FALKAN
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 MAGNOLIA AVE
Mailing Address - Street 2:
Mailing Address - City:LARKSPUR
Mailing Address - State:CA
Mailing Address - Zip Code:94939-1132
Mailing Address - Country:US
Mailing Address - Phone:415-927-2787
Mailing Address - Fax:
Practice Address - Street 1:1640 TIBURON BLVD
Practice Address - Street 2:
Practice Address - City:BELVEDERE TIBURON
Practice Address - State:CA
Practice Address - Zip Code:94920-2515
Practice Address - Country:US
Practice Address - Phone:415-435-7420
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-31
Last Update Date:2012-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA9243171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist