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General NPI Number Information
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NPI Number | 1720807258
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Entity Type | Organization
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Legal Business Name | INSTITUTE OF ACUPUNCTURE AND LIFESTYLE MEDICINE, INC
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Dates
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Enumeration Date | 10/10/2024
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Last Update Date | 10/10/2024
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Provider Practice Location Address
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Address Line | 30131 TOWN CENTER DR STE 270
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City | LAGUNA NIGUEL
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State | CA
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Zip | 92677-2082
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Country | US
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Telephone | 949-229-5055
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Fax | 714-362-2337
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Provider Business Mailing Address
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Address Line | 31961 VIA GALLO
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City | TRABUCO CANYON
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State | CA
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Zip | 92679-3935
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Country | US
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Telephone | 310-863-5484
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Fax | 714-362-2337
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | NILOOFAR NIKPOUR
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Credential | LAC, MTOM
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Telephone | 949-229-5055
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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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