Individual
BE THI DIEP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.C., ATC
Contact information
Practice address
17461 IRVINE BLVD STE P, TUSTIN, CA 92780-3026
(949) 929-0585
Mailing address
17461 IRVINE BLVD STE P, TUSTIN, CA 92780-3026
(949) 929-0585
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
DC36763
CA
2255A2300X
Athletic Trainer
2000052716
CA
Other
Enumeration date
09/19/2023
Last updated
09/19/2023
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