Individual
BRET JAMES ELLINGTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
L.AC.
Contact information
Practice address
22762 ASPAN ST, SUITE 201, LAKE FOREST, CA 92630-1604
(949) 235-9494
Mailing address
23785 EL TORO RD, SUITE 111, LAKE FOREST, CA 92630-4762
(949) 235-9494
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
AC 11948
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AC11948
MEDICARE P-TAN #
CA
Enumeration date
11/26/2007
Last updated
02/27/2014
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