1992766513 NPI number — MS. MICHELE GAIL-MARIE LAMARCHE L.AC., MTOM, ACN, NB

Table of content: (NPI 1285288019)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1992766513 NPI number — MS. MICHELE GAIL-MARIE LAMARCHE L.AC., MTOM, ACN, NB

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LAMARCHE
Provider First Name:
MICHELE
Provider Middle Name:
GAIL-MARIE
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
L.AC., MTOM, ACN, NB
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1992766513
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/20/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
11340 OLYMPIC BOULEVARD
Provider Second Line Business Mailing Address:
SUITE 301
Provider Business Mailing Address City Name:
LOS ANGELES
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
90064
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
310-422-1692
Provider Business Mailing Address Fax Number:
310-390-7836

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
11340 OLYMPIC BOULEVARD
Provider Second Line Business Practice Location Address:
SUITE 301
Provider Business Practice Location Address City Name:
LOS ANGELES
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90064
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
310-422-1692
Provider Business Practice Location Address Fax Number:
310-622-4188
Provider Enumeration Date:
03/31/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 171100000X , with the licence number:  AC8294 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 133N00000X , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)





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