Healthcare Provider Details

I. General information

NPI: 1851657787
Provider Name (Legal Business Name): ELLA ASHABI ACUPUNCTURE INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/04/2012
Last Update Date: 09/15/2020
Certification Date: 09/15/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23722 BIRTCHER DR
LAKE FOREST CA
92630-1771
US

IV. Provider business mailing address

12921 FAIRHAVEN EXT
SANTA ANA CA
92705-1357
US

V. Phone/Fax

Practice location:
  • Phone: 949-344-9707
  • Fax: 949-916-6659
Mailing address:
  • Phone: 949-955-9499
  • Fax: 949-916-6659

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: ELLA ASHABI
Title or Position: OWNER
Credential: LAC PHD
Phone: 949-955-9499