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General NPI Number Information
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NPI Number | 1477922110
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Entity Type | Organization
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Legal Business Name | STANTON UNIVERSITY
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Dates
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Enumeration Date | 09/23/2015
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Last Update Date | 09/23/2015
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Provider Practice Location Address
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Address Line | 9618 GARDEN GROVE BLVD SUITE 221
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City | GARDEN GROVE
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State | CA
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Zip | 92844-1563
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Country | US
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Telephone | 714-539-6562
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Fax | 714-539-6542
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Provider Business Mailing Address
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Address Line | 9618 GARDEN GROVE BLVD SUITE 221
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City | GARDEN GROVE
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State | CA
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Zip | 92844-1563
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Country | US
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Telephone | 714-539-6562
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Fax | 714-539-6542
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Authorized Official
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Title or Position | CLINIC DOCTOR
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Name | DR. THOMAS J LEE
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Credential | DOM
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Telephone | 714-539-6562
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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 |
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License Number State |
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