# ELYSIA LIFE CARE

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1619357415
- **Authorized official:** DR. CARLA VIDOR L.AC DAOM (COO)
- **Authorized official phone:** (310) 924-5205

## Contact information

- **Practice address:** 1821 WILSHIRE BLVD STE 500, SANTA MONICA, CA 90403-5679
- **Practice address phone:** (424) 744-8366
- **Mailing address:** 1821 WILSHIRE BLVD STE 500, SANTA MONICA, CA 90403-5679

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 171100000X | Acupuncturist | AC13025 | CA | Yes |

## Other

- **Enumeration date:** 06/05/2015
- **Last updated:** 06/05/2015