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General NPI Number Information
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NPI Number | 1427718170
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Entity Type | Organization
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Legal Business Name | DAN TIAN HOLISTIC CENTER INC
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Dates
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Enumeration Date | 12/22/2021
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Last Update Date | 12/05/2024
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Provider Practice Location Address
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Address Line | 43 CORPORATE PARK STE 205
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City | IRVINE
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State | CA
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Zip | 92606-5180
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Country | US
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Telephone | 949-382-1652
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Fax |
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Provider Business Mailing Address
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Address Line | 4521 CAMPUS DR STE 386
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City | IRVINE
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State | CA
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Zip | 92612-2621
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | BILLER
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Name | CHRISTINE L
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Credential |
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Telephone | 949-382-1652
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NN1001X
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Taxonomy Name | Nutrition Chiropractor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number |
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License Number State |
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