Healthcare Provider Details

I. General information

NPI: 1003254517
Provider Name (Legal Business Name): LAURA FLOWERS L.AC.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/06/2013
Last Update Date: 10/12/2022
Certification Date: 10/12/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15708 POMERADO RD STE N-203
POWAY CA
92064-2066
US

IV. Provider business mailing address

16381 HIGHLAND MESA DR
ESCONDIDO CA
92025-3508
US

V. Phone/Fax

Practice location:
  • Phone: 619-252-0045
  • Fax:
Mailing address:
  • Phone: 619-252-0045
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number17697
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number25 004081
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: