| NPI | 1619403854 |
|---|---|
| Doing Business As | TUSTIN LONGEVITY CENTER |
| Entity Type | Organization |
| Authorized Contact | TALON ELLITHORPE Practice Manager 714-805-6173 |
| Organization Subpart ? | No |
| Primary Taxonomy | 405300000X Prevention Professional (Licence: CA G83575) |
| Enumeration Date | 2017-05-09 |
| Last Update Date | 2025-04-22 |