Healthcare Provider Details

I. General information

NPI: 1073241204
Provider Name (Legal Business Name): LIFE GIVING ACUPUNCTURE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/15/2022
Last Update Date: 08/15/2022
Certification Date: 08/15/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26700 TOWNE CENTRE DR STE 250
FOOTHILL RANCH CA
92610-2854
US

IV. Provider business mailing address

26700 TOWNE CENTRE DR STE 250
FOOTHILL RANCH CA
92610-2854
US

V. Phone/Fax

Practice location:
  • Phone: 949-365-4885
  • Fax:
Mailing address:
  • Phone: 949-365-4885
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State

VIII. Authorized Official

Name: MERCY PARK
Title or Position: CEO/LAC
Credential:
Phone: 213-800-3692