Provider Demographics
NPI:1912235896
Name:DUNN, MICHAEL (LAC)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:
Last Name:DUNN
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 1:5701 W SLAUSON AVE STE 108
Mailing Address - Street 2:
Mailing Address - City:CULVER CITY
Mailing Address - State:CA
Mailing Address - Zip Code:90230-3423
Mailing Address - Country:US
Mailing Address - Phone:310-948-3540
Mailing Address - Fax:
Practice Address - Street 1:5701 W. SLAUSON AVE
Practice Address - Street 2:SUITE #108
Practice Address - City:CULVER CITY
Practice Address - State:CA
Practice Address - Zip Code:90230-6523
Practice Address - Country:US
Practice Address - Phone:310-948-3540
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-03
Last Update Date:2010-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC 5869171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist