Provider Demographics
NPI:1033902218
Name:LASKO, ELISE (DACM, LAC)
Entity type:Individual
Prefix:DR
First Name:ELISE
Middle Name:
Last Name:LASKO
Suffix:
Gender:F
Credentials:DACM, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5427 STIRRUP WAY
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92057-5514
Mailing Address - Country:US
Mailing Address - Phone:330-509-1706
Mailing Address - Fax:
Practice Address - Street 1:2210 E VISTA WAY STE 2
Practice Address - Street 2:
Practice Address - City:VISTA
Practice Address - State:CA
Practice Address - Zip Code:92084-2755
Practice Address - Country:US
Practice Address - Phone:760-283-6745
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-28
Last Update Date:2025-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC20320171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist