Provider Demographics
NPI:1104291418
Name:ESCONDIDO HEALING CENTER
Entity type:Organization
Organization Name:ESCONDIDO HEALING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:HERSHMAN
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:760-644-4228
Mailing Address - Street 1:11130 ARCO DR
Mailing Address - Street 2:
Mailing Address - City:ESCONDIDO
Mailing Address - State:CA
Mailing Address - Zip Code:92026-8514
Mailing Address - Country:US
Mailing Address - Phone:760-644-4228
Mailing Address - Fax:760-294-6835
Practice Address - Street 1:11130 ARCO DR
Practice Address - Street 2:
Practice Address - City:ESCONDIDO
Practice Address - State:CA
Practice Address - Zip Code:92026
Practice Address - Country:US
Practice Address - Phone:760-644-4228
Practice Address - Fax:760-294-6835
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-11
Last Update Date:2018-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC8783171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty