Healthcare Provider Details
I. General information
NPI: 1174468573
Provider Name (Legal Business Name): RADIANT ACUPUNCTURE
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/22/2026
Last Update Date: 04/22/2026
Certification Date: 04/21/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
17897 MACARTHUR BLVD
IRVINE CA
92614-0533
US
IV. Provider business mailing address
17897 MACARTHUR BLVD
IRVINE CA
92614-0533
US
V. Phone/Fax
- Phone: 949-310-9550
- Fax: 949-868-7174
- Phone: 949-310-9550
- Fax: 949-868-7174
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 171100000X |
| Taxonomy | Acupuncturist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
AH
CHU
Title or Position: PRACTITIONER
Credential: L. AC.
Phone: 949-310-9550