Provider Demographics
NPI:1568979128
Name:LIGHTER ACUPUNCTURE & INTEGRATIVE HEALTH INC
Entity Type:Organization
Organization Name:LIGHTER ACUPUNCTURE & INTEGRATIVE HEALTH INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINIC DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:RACHEL
Authorized Official - Middle Name:
Authorized Official - Last Name:RYCHLOCK
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:949-546-7865
Mailing Address - Street 1:15212 HENRY WAY
Mailing Address - Street 2:
Mailing Address - City:TUSTIN
Mailing Address - State:CA
Mailing Address - Zip Code:92782-1766
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:43 CORPORATE PARK STE 204
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92606-5137
Practice Address - Country:US
Practice Address - Phone:949-546-7865
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-04
Last Update Date:2018-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA16962171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty