Provider Demographics
NPI:1700217346
Name:NEW LIFE WELLNESS LLC
Entity Type:Organization
Organization Name:NEW LIFE WELLNESS LLC
Other - Org Name:DANTIAN WELLNESS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:GUIQIN
Authorized Official - Middle Name:
Authorized Official - Last Name:AN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-351-0280
Mailing Address - Street 1:13844 ALTON PKWY
Mailing Address - Street 2:SUITE 134
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92618-1620
Mailing Address - Country:US
Mailing Address - Phone:949-436-3376
Mailing Address - Fax:800-665-1218
Practice Address - Street 1:13844 ALTON PKWY
Practice Address - Street 2:SUITE 134
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92618-1620
Practice Address - Country:US
Practice Address - Phone:949-436-3376
Practice Address - Fax:800-665-1218
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-09
Last Update Date:2014-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA11888171100000X
CA14346173C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty
No173C00000XOther Service ProvidersReflexologistGroup - Multi-Specialty