Provider Demographics
NPI:1023276698
Name:TALAMANTES, OSCAR (LAC)
Entity type:Individual
Prefix:
First Name:OSCAR
Middle Name:
Last Name:TALAMANTES
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2827 ARIZONA AVE
Mailing Address - Street 2:E
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90404-1525
Mailing Address - Country:US
Mailing Address - Phone:760-774-1817
Mailing Address - Fax:
Practice Address - Street 1:2827 ARIZONA AVE
Practice Address - Street 2:E
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90404-1525
Practice Address - Country:US
Practice Address - Phone:760-774-1817
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-29
Last Update Date:2008-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA12424171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist