Provider Demographics
NPI:1104067354
Name:JULIEN, MICHAEL R I (LAC)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:R
Last Name:JULIEN
Suffix:I
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 1:6717 LIMONITE CT
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92009-5202
Mailing Address - Country:US
Mailing Address - Phone:858-216-4419
Mailing Address - Fax:858-876-1987
Practice Address - Street 1:1011 DEVONSHIRE DR STE B
Practice Address - Street 2:
Practice Address - City:ENCINITAS
Practice Address - State:CA
Practice Address - Zip Code:92024-5136
Practice Address - Country:US
Practice Address - Phone:858-216-4419
Practice Address - Fax:858-876-1987
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-18
Last Update Date:2017-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA12866171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist