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General NPI Number Information
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NPI Number | 1851809347
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Entity Type | Organization
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Legal Business Name | IRVINE WELLNESS CENTER
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Dates
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Enumeration Date | 01/18/2018
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Last Update Date | 01/18/2018
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Provider Practice Location Address
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Address Line | 15370 ALTON PKWY
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City | IRVINE
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State | CA
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Zip | 92618-2362
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Country | US
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Telephone | 949-727-4005
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Fax | 888-766-6190
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Provider Business Mailing Address
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Address Line | 402 ROCKEFELLER UNIT 308
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City | IRVINE
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State | CA
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Zip | 92612-8106
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Country | US
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Telephone | 949-727-4005
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | QI ZHANG
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Credential | ACUPUNCTURIST
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Telephone | 949-500-0433
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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 | AC4983
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License Number State | CA
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