Provider Demographics
NPI:1053482406
Name:LIU, CHUN YANG (LAC OMD)
Entity Type:Individual
Prefix:DR
First Name:CHUN YANG
Middle Name:
Last Name:LIU
Suffix:
Gender:F
Credentials:LAC OMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1762 18TH AVE
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94122-4506
Mailing Address - Country:US
Mailing Address - Phone:415-379-9863
Mailing Address - Fax:415-681-2768
Practice Address - Street 1:3900 GEARY BLVD STE 203
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94118-3251
Practice Address - Country:US
Practice Address - Phone:415-379-9863
Practice Address - Fax:415-681-2768
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC4901171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist