Provider Demographics
NPI:1699036780
Name:LANAHAN ENTERPRISES, INC
Entity Type:Organization
Organization Name:LANAHAN ENTERPRISES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ACUPUNCTURIST
Authorized Official - Prefix:
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:TALBOT
Authorized Official - Last Name:LANAHAN
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:760-652-1116
Mailing Address - Street 1:451 LA VETA AVE
Mailing Address - Street 2:
Mailing Address - City:ENCINITAS
Mailing Address - State:CA
Mailing Address - Zip Code:92024-2014
Mailing Address - Country:US
Mailing Address - Phone:760-652-1116
Mailing Address - Fax:
Practice Address - Street 1:451 LA VETA AVE
Practice Address - Street 2:
Practice Address - City:ENCINITAS
Practice Address - State:CA
Practice Address - Zip Code:92024-2014
Practice Address - Country:US
Practice Address - Phone:760-652-1116
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-05
Last Update Date:2012-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA11360171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty