Individual
CYNTHIA M BOUGOUKALOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.AC., DIPL. AC.
Contact information
Practice address
11750 W. SUNSET BLVD. SUITE 501, LOS ANGELES, CA 90049-2995
(310) 266-4040
Mailing address
11750 W SUNSET BLVD, SUITE 501, LOS ANGELES, CA 90049-2960
(310) 266-4040
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
8896
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1053522763
BLUE CROSS/BLUE SHIELD
CA
Enumeration date
05/24/2007
Last updated
03/16/2009
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