Healthcare Provider Details

I. General information

NPI: 1225671340
Provider Name (Legal Business Name): LUIS ESPINOSA OMANA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/21/2019
Last Update Date: 04/13/2026
Certification Date: 04/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

251 E AVENUE K6 STE H
LANCASTER CA
93535-4513
US

IV. Provider business mailing address

251 E AVENUE K6 STE H
LANCASTER CA
93535-4513
US

V. Phone/Fax

Practice location:
  • Phone: 661-974-8400
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code373H00000X
TaxonomyDay Training/Habilitation Specialist
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: