Provider Demographics
NPI:1518398841
Name:HERBAL WISDOM
Entity Type:Organization
Organization Name:HERBAL WISDOM
Other - Org Name:DANTIAN THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:XUNHAI
Authorized Official - Middle Name:
Authorized Official - Last Name:LIU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-351-0280
Mailing Address - Street 1:6650 IRVINE CENTER DR
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92618-2117
Mailing Address - Country:US
Mailing Address - Phone:949-351-0280
Mailing Address - Fax:800-665-1218
Practice Address - Street 1:6650 IRVINE CENTER DR
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92618-2117
Practice Address - Country:US
Practice Address - Phone:949-351-0280
Practice Address - Fax:800-665-1218
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-12
Last Update Date:2014-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC 28718111N00000X
CAAC 11888171100000X
CAAC 7591171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty