Provider Demographics
NPI:1669228649
Name:LAURA CAPINA
Entity type:Organization
Organization Name:LAURA CAPINA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACUPUNCTURIST
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:CAPINA
Authorized Official - Suffix:
Authorized Official - Credentials:LAC,PHD
Authorized Official - Phone:714-713-4531
Mailing Address - Street 1:10 FATHOM DR
Mailing Address - Street 2:
Mailing Address - City:CORONA DEL MAR
Mailing Address - State:CA
Mailing Address - Zip Code:92625-1417
Mailing Address - Country:US
Mailing Address - Phone:714-713-4531
Mailing Address - Fax:
Practice Address - Street 1:1601 DOVE ST STE 190
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-2441
Practice Address - Country:US
Practice Address - Phone:714-713-4531
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-29
Last Update Date:2024-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center