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General NPI Number Information
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NPI Number | 1164174942
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Entity Type | Individual
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Provider Name | COURTNEY BIRD LAC
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Gender | Female
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Dates
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Enumeration Date | 01/22/2022
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Last Update Date | 01/22/2022
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Provider Practice Location Address
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Address Line | 16485 LAGUNA CANYON RD STE 105
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City | IRVINE
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State | CA
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Zip | 92618-3833
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Country | US
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Telephone | 949-646-4325
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Fax |
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Provider Business Mailing Address
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Address Line | 16927 NORFOLK CIR
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City | YORBA LINDA
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State | CA
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Zip | 92886-4817
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Country | US
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Telephone | 949-415-9924
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | 19341
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License Number State | CA
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