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General NPI Number Information
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NPI Number | 1336504414
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Entity Type | Organization
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Legal Business Name | CY ACUPUNCTURE WELLNESS CENTER
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Dates
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Enumeration Date | 12/16/2015
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Last Update Date | 12/16/2015
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Provider Practice Location Address
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Address Line | 23361 EL TORO RD SUITE 108
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City | LAKE FOREST
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State | CA
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Zip | 92630-6922
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Country | US
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Telephone | 949-679-1919
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Fax |
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Provider Business Mailing Address
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Address Line | 23361 EL TORO RD SUITE 108
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City | LAKE FOREST
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State | CA
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Zip | 92630-6922
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Country | US
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Telephone | 949-679-1919
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Fax |
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Authorized Official
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Title or Position | PARTNER
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Name | TING FANG CHIN MADRINAN
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Credential |
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Telephone | 626-831-8010
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP3300X
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Taxonomy Name | Pain Clinic/Center
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License Number |
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License Number State |
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