Healthcare Provider Details

I. General information

NPI: 1124560685
Provider Name (Legal Business Name): LOUISE HELEN ESQUE L. AC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/15/2016
Last Update Date: 11/15/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1755 ORANGE AVE SUITE E
COSTA MESA CA
92627-3130
US

IV. Provider business mailing address

1755 ORANGE AVE SUITE E
COSTA MESA CA
92627-3130
US

V. Phone/Fax

Practice location:
  • Phone: 562-242-9903
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number16055
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: