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General NPI Number Information
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NPI Number | 1881999274
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Entity Type | Organization
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Legal Business Name | OC GREENCARE, INC.
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Dates
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Enumeration Date | 01/17/2011
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Last Update Date | 01/17/2011
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Provider Practice Location Address
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Address Line | 7020 TRASK AVE
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City | WESTMINSTER
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State | CA
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Zip | 92683-2622
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Country | US
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Telephone | 714-855-1104
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Fax |
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Provider Business Mailing Address
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Address Line | 7020 TRASK AVE
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City | WESTMINSTER
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State | CA
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Zip | 92683-2622
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Country | US
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Telephone | 714-855-1104
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Fax |
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Authorized Official
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Title or Position | ACUPUNCTURIST
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Name | MS. LILY DANZHI LI
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Credential | ACUPUNCTURIST
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Telephone | 714-855-1104
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 305R00000X
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Taxonomy Name | Preferred Provider Organization
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License Number | AC6047
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License Number State | CA
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