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General NPI Number Information
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NPI Number | 1285241596
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Entity Type | Individual
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Provider Name | MARION JANE DUNHAM LAC
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Gender | Female
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Dates
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Enumeration Date | 09/30/2020
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Last Update Date | 07/23/2024
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Provider Practice Location Address
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Address Line | 3273 CASITAS AVE STE 106
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City | LOS ANGELES
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State | CA
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Zip | 90039-2205
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Country | US
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Telephone | 415-632-8947
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Fax |
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Provider Business Mailing Address
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Address Line | 1048 EVERETT PL APT 3
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City | LOS ANGELES
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State | CA
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Zip | 90026-4446
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Country | US
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Telephone | 415-632-8947
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | 18936
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License Number State | CA
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