Provider Demographics
NPI:1730206863
Name:CHI THERAPY CENTER
Entity type:Organization
Organization Name:CHI THERAPY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:QI
Authorized Official - Middle Name:
Authorized Official - Last Name:ZHANG
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:949-500-0433
Mailing Address - Street 1:1303 AVOCADO AVE
Mailing Address - Street 2:SUITE # 110
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-7802
Mailing Address - Country:US
Mailing Address - Phone:949-500-0433
Mailing Address - Fax:949-727-4005
Practice Address - Street 1:1303 AVOCADO AVE
Practice Address - Street 2:SUITE # 110
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-7802
Practice Address - Country:US
Practice Address - Phone:949-500-0433
Practice Address - Fax:949-727-4005
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-23
Last Update Date:2018-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC18270111N00000X
CAAC11888171100000X
CAAC4983171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA=========OtherEIN