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General NPI Number Information
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NPI Number | 1720484058
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Entity Type | Individual
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Provider Name | NATHAN YEARGIN D.C., L.AC.
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Gender | Male
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Dates
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Enumeration Date | 11/13/2014
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Last Update Date | 09/04/2020
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Provider Practice Location Address
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Address Line | 12721 NEWPORT AVE STE 2
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City | TUSTIN
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State | CA
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Zip | 92780-8031
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Country | US
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Telephone | 657-333-6061
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Fax |
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Provider Business Mailing Address
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Address Line | 17251 17TH ST STE A
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City | TUSTIN
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State | CA
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Zip | 92780-1963
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Country | US
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Telephone | 657-333-6061
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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 | 16336
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 32863
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License Number State | CA
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