Organization
DR. LIFESTYLE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICAH YU (VICE PRESIDENT)
(909) 837-0735
Entity
Organization
Contact information
Practice address
1501 WESTCLIFF DR STE 201, NEWPORT BEACH, CA 92660-5518
(949) 569-8877
Mailing address
1501 WESTCLIFF DR STE 201, NEWPORT BEACH, CA 92660-5518
(949) 569-8877
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
10/02/2020
Last updated
12/09/2020
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