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Organization
LIVE TILL 100, INC.
Active
Organization
LIVE TILL 100, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MITZIE LAM DC (PRESIDENT/OWNER)
(714) 470-6911
Entity
Organization
Contact information
Practice address
7895 WESTMINSTER BLVD, WESTMINSTER, CA 92683-4043
(714) 893-1222
(714) 893-1244
Mailing address
7695 ENCINAS CIR, WESTMINSTER, CA 92683-3210
(714) 470-6911
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
DC30128
CA
Other
Enumeration date
06/17/2016
Last updated
06/17/2016
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