Provider Demographics
NPI:1245537190
Name:ORENSTEIN, SUSAN (LAC)
Entity type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:
Last Name:ORENSTEIN
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2206 BALBOA AVE
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92109-4735
Mailing Address - Country:US
Mailing Address - Phone:858-866-6688
Mailing Address - Fax:858-866-5644
Practice Address - Street 1:2206 BALBOA AVE
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92109-4735
Practice Address - Country:US
Practice Address - Phone:858-866-6688
Practice Address - Fax:858-866-5644
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-11
Last Update Date:2011-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC9452171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist