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General NPI Number Information
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NPI Number | 1831562487
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Entity Type | Organization
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Legal Business Name | CORE INTEGRATED HEALTH
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Dates
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Enumeration Date | 11/04/2015
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Last Update Date | 11/04/2015
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Provider Practice Location Address
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Address Line | 10801 FOOTHILL BLVD SUITE 104
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City | RANCHO CUCAMONGA
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State | CA
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Zip | 91730-7694
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Country | US
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Telephone | 909-989-4435
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Fax | 909-989-4461
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Provider Business Mailing Address
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Address Line | 10801 FOOTHILL BLVD SUITE 104
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City | RANCHO CUCAMONGA
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State | CA
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Zip | 91730-7694
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Country | US
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Telephone | 909-989-4435
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Fax | 909-989-4461
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Authorized Official
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Title or Position | OWNER, CLINIC DIRECTOR
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Name | DR. CORAZON C LANYON
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Credential | DC
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Telephone | 909-989-4435
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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 | AC 11452
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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 | 23557
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License Number State | CA
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