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General NPI Number Information
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NPI Number | 1104291418
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Entity Type | Organization
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Legal Business Name | ESCONDIDO HEALING CENTER
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Dates
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Enumeration Date | 12/11/2015
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Last Update Date | 07/24/2018
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Provider Practice Location Address
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Address Line | 11130 ARCO DR
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City | ESCONDIDO
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State | CA
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Zip | 92026
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Country | US
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Telephone | 760-644-4228
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Fax | 760-294-6835
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Provider Business Mailing Address
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Address Line | 11130 ARCO DR
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City | ESCONDIDO
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State | CA
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Zip | 92026-8514
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Country | US
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Telephone | 760-644-4228
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Fax | 760-294-6835
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Authorized Official
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Title or Position | PRESIDENT
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Name | KAREN HERSHMAN
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Credential | LAC
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Telephone | 760-644-4228
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | AC8783
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License Number State | CA
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