Provider Demographics
NPI:1689014342
Name:AHLBORN, THOMAS EDWARD (PHD LAC)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:EDWARD
Last Name:AHLBORN
Suffix:
Gender:M
Credentials:PHD LAC
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Mailing Address - Street 1:1735 WESTWOOD DR
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:CA
Mailing Address - Zip Code:94521-1233
Mailing Address - Country:US
Mailing Address - Phone:925-826-9102
Mailing Address - Fax:925-977-1639
Practice Address - Street 1:1111 CIVIC DR
Practice Address - Street 2:SUITE 111
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94596-3895
Practice Address - Country:US
Practice Address - Phone:925-977-1638
Practice Address - Fax:925-977-1639
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-26
Last Update Date:2013-06-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAAC 15264171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist