Provider Demographics
NPI:1407111750
Name:DANTIAN THERAPY ACUPUNCTURE
Entity Type:Organization
Organization Name:DANTIAN THERAPY ACUPUNCTURE
Other - Org Name:DANTIAN THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DANTIAN
Authorized Official - Middle Name:TING
Authorized Official - Last Name:LIU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-855-8948
Mailing Address - Street 1:45 AUTO CENTER DR
Mailing Address - Street 2:#108
Mailing Address - City:FOOTHILL RANCH
Mailing Address - State:CA
Mailing Address - Zip Code:92610-2848
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:45 AUTO CENTER DR
Practice Address - Street 2:#108
Practice Address - City:FOOTHILL RANCH
Practice Address - State:CA
Practice Address - Zip Code:92610-2848
Practice Address - Country:US
Practice Address - Phone:949-855-8948
Practice Address - Fax:800-665-1218
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-11
Last Update Date:2012-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC 28718111N00000X
CAAC 13611171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty