Healthcare Provider Details

I. General information

NPI: 1235404310
Provider Name (Legal Business Name): DEBORAH ELISE OHLS L. AC.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/21/2012
Last Update Date: 03/21/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1149 N 2ND ST
EL CAJON CA
92021-5024
US

IV. Provider business mailing address

10800 WOODSIDE AVE 46
SANTEE CA
92071-3137
US

V. Phone/Fax

Practice location:
  • Phone: 619-200-6911
  • Fax:
Mailing address:
  • Phone: 619-200-6911
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number12707
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: