Provider Demographics
NPI:1104456078
Name:MURRAY, STEVEN LORAN (DACM LAC)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:LORAN
Last Name:MURRAY
Suffix:
Gender:M
Credentials:DACM LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6502 ZENA DR
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92115-7028
Mailing Address - Country:US
Mailing Address - Phone:951-553-6855
Mailing Address - Fax:
Practice Address - Street 1:300 N BRANDON RD STE 1
Practice Address - Street 2:
Practice Address - City:FALLBROOK
Practice Address - State:CA
Practice Address - Zip Code:92028-2207
Practice Address - Country:US
Practice Address - Phone:951-553-6855
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-20
Last Update Date:2020-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA18288171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist