Provider Demographics
NPI:1063794246
Name:HINDS, EARL S (LAC)
Entity type:Individual
Prefix:MR
First Name:EARL
Middle Name:S
Last Name:HINDS
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 1:1300 SOUTHAMPTON RD APT 8
Mailing Address - Street 2:
Mailing Address - City:BENICIA
Mailing Address - State:CA
Mailing Address - Zip Code:94510-1736
Mailing Address - Country:US
Mailing Address - Phone:707-567-2624
Mailing Address - Fax:707-750-5226
Practice Address - Street 1:701 SOUTHAMPTON RD STE 207
Practice Address - Street 2:
Practice Address - City:BENICIA
Practice Address - State:CA
Practice Address - Zip Code:94510-2075
Practice Address - Country:US
Practice Address - Phone:707-567-2624
Practice Address - Fax:707-750-5226
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-14
Last Update Date:2023-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACA 12527171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist