Individual
DALE EDWARD FANNING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LAC
Contact information
Practice address
1700 SHATTUCK AVE, BERKELEY, CA 94709-3402
(510) 847-9706
(888) 522-6692
Mailing address
1436 BLAKE ST, BERKELEY, CA 94702-2104
(206) 979-4510
(888) 522-6692
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
AC 15988
CA
Other
Enumeration date
05/26/2014
Last updated
05/26/2014
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