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NPI Code Detail

MEDICARE: THE ENSPIRIT WELLNESS PROJECT

MEDICARE: THE ENSPIRIT WELLNESS PROJECT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1171100000XAcupuncturistAC12456CA

General Provider Information

NPI Number : 1326411901
Entity Type Code : Organization
Provider Name (Legal Business Name) : THE ENSPIRIT WELLNESS PROJECT
Provider Business Mailing Address
First Line : 20 FAIRBANKS
Second Line : STE 180
City : IRVINE
State : CA
Zip : 92618-1624
Country : US
Telephone Number : 562-449-2676
Fax Number :
Provider Business Practice Location Address
First Line : 453 S SPRING ST
Second Line : SUITE 320
City : LOS ANGELES
State : CA
Zip : 90013-2013
Country : US
Telephone Number : 562-449-2676
Fax Number :
Authorized Official
Title or Position : BOARD CHAIR
Name : MR. HOLLY ELISABETH ANDERSON
Credential : LAC
Telephone Number : 562-449-2676
Provider Enumeration Date : 11/04/2015
Last Update Date : 11/04/2015

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Directions to “THE ENSPIRIT WELLNESS PROJECT ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.