Provider Demographics
NPI:1265672273
Name:VASQUEZ, LILIANA (LAC)
Entity Type:Individual
Prefix:MISS
First Name:LILIANA
Middle Name:
Last Name:VASQUEZ
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 1:2175 TERMINO AVE
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90815-2662
Mailing Address - Country:US
Mailing Address - Phone:714-240-6448
Mailing Address - Fax:
Practice Address - Street 1:7230 MEDICAL CENTER DR
Practice Address - Street 2:SUITE 400
Practice Address - City:WEST HILLS
Practice Address - State:CA
Practice Address - Zip Code:91307-1907
Practice Address - Country:US
Practice Address - Phone:818-251-1965
Practice Address - Fax:818-251-1969
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-03
Last Update Date:2009-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC11550171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist