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General NPI Number Information
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NPI Number | 1417758392
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Entity Type | Organization
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Legal Business Name | ESSI CA, PC
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Dates
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Enumeration Date | 03/24/2025
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Last Update Date | 03/24/2025
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Provider Practice Location Address
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Address Line | 4772 KATELLA AVE STE 200
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City | LOS ALAMITOS
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State | CA
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Zip | 90720-2683
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Country | US
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Telephone | 516-584-8710
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Fax | 516-584-8711
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Provider Business Mailing Address
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Address Line | 1110 N VIRGIL AVE PMB 93712
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City | LOS ANGELES
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State | CA
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Zip | 90029
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Country | US
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Telephone | 516-584-8710
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Fax | 516-584-8711
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Authorized Official
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Title or Position | BUSINESS ADMINISTRATOR
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Name | JUDY LAWRENCE
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Credential |
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Telephone | 631-456-2514
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208C00000X
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Taxonomy Name | Colon & Rectal Surgery Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number |
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License Number State |
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