Provider Demographics
NPI:1750882254
Name:ALDINE, ALIAA (LAC, MD (RU))
Entity type:Individual
Prefix:DR
First Name:ALIAA
Middle Name:
Last Name:ALDINE
Suffix:
Gender:F
Credentials:LAC, MD (RU)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:781 SOLITO CT
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95123-3945
Mailing Address - Country:US
Mailing Address - Phone:650-554-0753
Mailing Address - Fax:
Practice Address - Street 1:900 N SAN ANTONIO RD STE 103
Practice Address - Street 2:
Practice Address - City:LOS ALTOS
Practice Address - State:CA
Practice Address - Zip Code:94022-1338
Practice Address - Country:US
Practice Address - Phone:650-554-0753
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-21
Last Update Date:2018-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA17972171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist