Provider Demographics
NPI:1366584864
Name:MERAV, YAEL (LAC DOM DIPL AC DIPL)
Entity type:Individual
Prefix:MS
First Name:YAEL
Middle Name:
Last Name:MERAV
Suffix:
Gender:F
Credentials:LAC DOM DIPL AC DIPL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16850 BOSQUE DR
Mailing Address - Street 2:
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91436-3531
Mailing Address - Country:US
Mailing Address - Phone:818-981-3979
Mailing Address - Fax:818-981-8636
Practice Address - Street 1:16545 VENTURA BLVD #24
Practice Address - Street 2:
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91436
Practice Address - Country:US
Practice Address - Phone:818-385-0775
Practice Address - Fax:818-981-8636
Is Sole Proprietor?:No
Enumeration Date:2007-02-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC6906171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist