Provider Demographics
NPI:1942382122
Name:KITTS, DAVID BRYAN (LAC)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:BRYAN
Last Name:KITTS
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 68
Mailing Address - Street 2:
Mailing Address - City:LAGUNITAS
Mailing Address - State:CA
Mailing Address - Zip Code:94938-0068
Mailing Address - Country:US
Mailing Address - Phone:415-269-0885
Mailing Address - Fax:415-927-9559
Practice Address - Street 1:45 SAN CLEMENTE DR
Practice Address - Street 2:SUITE B 120
Practice Address - City:CORTE MADERA
Practice Address - State:CA
Practice Address - Zip Code:94925-1244
Practice Address - Country:US
Practice Address - Phone:415-269-0885
Practice Address - Fax:415-927-9559
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA2907171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist