Provider Demographics
NPI:1912152372
Name:KENIN, AARON LEON (LAC)
Entity Type:Individual
Prefix:MR
First Name:AARON LEON
Middle Name:
Last Name:KENIN
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 29TH ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94609-3519
Mailing Address - Country:US
Mailing Address - Phone:510-504-2735
Mailing Address - Fax:510-836-0400
Practice Address - Street 1:401 29TH ST
Practice Address - Street 2:SUITE 101
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94609-3519
Practice Address - Country:US
Practice Address - Phone:510-504-2735
Practice Address - Fax:510-836-0400
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-25
Last Update Date:2013-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC 12276171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist