Provider Demographics
NPI:1437537636
Name:NA, LOUIS
Entity Type:Individual
Prefix:
First Name:LOUIS
Middle Name:
Last Name:NA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11951 GAIL LN
Mailing Address - Street 2:
Mailing Address - City:GARDEN GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:92840-2517
Mailing Address - Country:US
Mailing Address - Phone:714-875-2359
Mailing Address - Fax:
Practice Address - Street 1:7342 ORANGETHORPE AVE
Practice Address - Street 2:B103
Practice Address - City:BUENA PARK
Practice Address - State:CA
Practice Address - Zip Code:90621-3326
Practice Address - Country:US
Practice Address - Phone:714-875-2359
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-08
Last Update Date:2015-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA16505171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist