Provider Demographics
NPI:1184832966
Name:LIU, YONGCONG (LAC)
Entity Type:Individual
Prefix:DR
First Name:YONGCONG
Middle Name:
Last Name:LIU
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:59 POPPY LN
Mailing Address - Street 2:
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94708-1407
Mailing Address - Country:US
Mailing Address - Phone:510-527-1329
Mailing Address - Fax:510-527-1329
Practice Address - Street 1:59 POPPY LN
Practice Address - Street 2:
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94708-1407
Practice Address - Country:US
Practice Address - Phone:510-527-1329
Practice Address - Fax:510-527-1329
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAL.AC5344171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist