Provider Demographics
NPI:1114143328
Name:LIN, TIFFANY HSIEH (MS L,AC)
Entity Type:Individual
Prefix:
First Name:TIFFANY
Middle Name:HSIEH
Last Name:LIN
Suffix:
Gender:F
Credentials:MS L,AC
Other - Prefix:
Other - First Name:TIFFANY
Other - Middle Name:
Other - Last Name:HSIEH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS LAC
Mailing Address - Street 1:25 VILLAGER
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92602-2459
Mailing Address - Country:US
Mailing Address - Phone:949-351-0320
Mailing Address - Fax:949-721-9653
Practice Address - Street 1:29819 SANTA MARGARITA PKWY STE A
Practice Address - Street 2:
Practice Address - City:RANCHO SANTA MARGARITA
Practice Address - State:CA
Practice Address - Zip Code:92688-3620
Practice Address - Country:US
Practice Address - Phone:949-351-0320
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC 10580171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist