Provider Demographics
NPI:1942505870
Name:ALTERNATIVE MEDICINE & NATURAL THERAPY INSTITUTE, A PROFESSIONAL CORP.
Entity Type:Organization
Organization Name:ALTERNATIVE MEDICINE & NATURAL THERAPY INSTITUTE, A PROFESSIONAL CORP.
Other - Org Name:DANTIAN THERAPY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
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:PHD
Authorized Official - Phone:949-855-8948
Mailing Address - Street 1:24531 TRABUCO RD
Mailing Address - Street 2:SUITE #C
Mailing Address - City:LAKE FOREST
Mailing Address - State:CA
Mailing Address - Zip Code:92630
Mailing Address - Country:US
Mailing Address - Phone:949-855-8948
Mailing Address - Fax:800-665-1218
Practice Address - Street 1:24531 TRABUCO RD
Practice Address - Street 2:SUITE #C
Practice Address - City:LAKE FOREST
Practice Address - State:CA
Practice Address - Zip Code:92630-2162
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:2011-01-25
Last Update Date:2011-08-18
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