Healthcare Provider Details

I. General information

NPI: 1437537636
Provider Name (Legal Business Name): LOUIS NA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/08/2015
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17291 IRVINE BLVD STE 455
TUSTIN CA
92780-2953
US

IV. Provider business mailing address

6785 KNOTT AVE APT 204
BUENA PARK CA
90620-1189
US

V. Phone/Fax

Practice location:
  • Phone: 714-875-2359
  • Fax:
Mailing address:
  • Phone: 714-875-2359
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number16505
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: