Individual
ELLEN LAZARES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.AC.
Contact information
Practice address
11685 MAGNOLIA BLVD, VALLEY VILLAGE, CA 91601-3065
(818) 506-0254
Mailing address
12605 JUNIPER HILLS RD, PEARBLOSSOM, CA 93553-3453
(818) 506-0254
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
AC3623
CA
Other
Enumeration date
03/27/2010
Last updated
03/27/2010
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