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General NPI Number Information
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NPI Number | 1881005965
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Entity Type | Organization
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Legal Business Name | ALIGN MEDICAL GROUP
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Dates
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Enumeration Date | 05/12/2014
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Last Update Date | 05/12/2014
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Provider Practice Location Address
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Address Line | 1125 E 17TH ST SUITE W-117
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City | SANTA ANA
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State | CA
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Zip | 92701-2201
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Country | US
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Telephone | 714-550-6399
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Fax | 714-550-6359
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Provider Business Mailing Address
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Address Line | 1125 E 17TH ST SUITE W-117
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City | SANTA ANA
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State | CA
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Zip | 92701-2201
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Country | US
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Telephone | 714-550-6399
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Fax | 714-550-6359
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. TRINIDAD CISNEROS
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Credential | D.C.
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Telephone | 949-394-2802
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | DC-14281
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 111NX0100X
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Taxonomy Name | Occupational Health Chiropractor
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License Number | DC-27592
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | AC-3734
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License Number State | CA
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Taxonomy #4
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | A100315
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License Number State | CA
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Taxonomy #5
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | DC-27592
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License Number State | CA
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