Provider Demographics
NPI:1427449024
Name:CORNERSTONE ACUPUNCTURE INSTITUTE, INC.
Entity type:Organization
Organization Name:CORNERSTONE ACUPUNCTURE INSTITUTE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:S
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:LAC, PHD
Authorized Official - Phone:949-424-6430
Mailing Address - Street 1:15785 LAGUNA CANYON ROAD
Mailing Address - Street 2:SUITE 330
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92618-3178
Mailing Address - Country:US
Mailing Address - Phone:949-424-6430
Mailing Address - Fax:949-612-0010
Practice Address - Street 1:15785 LAGUNA CANYON ROAD
Practice Address - Street 2:SUITE 330
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92618-3178
Practice Address - Country:US
Practice Address - Phone:949-424-6430
Practice Address - Fax:949-612-0010
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-18
Last Update Date:2022-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA33179111N00000X
111N00000X, 171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA9703241Medicaid