Provider Demographics
NPI:1295819472
Name:LU, LIYAN (ACUPUNCTURIST)
Entity Type:Individual
Prefix:
First Name:LIYAN
Middle Name:
Last Name:LU
Suffix:
Gender:F
Credentials:ACUPUNCTURIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27600 BOUQUET CANYON RD STE 118
Mailing Address - Street 2:
Mailing Address - City:SANTA CLARITA
Mailing Address - State:CA
Mailing Address - Zip Code:91350-3719
Mailing Address - Country:US
Mailing Address - Phone:661-513-9265
Mailing Address - Fax:
Practice Address - Street 1:27600 BOUQUET CANYON RD STE 118
Practice Address - Street 2:
Practice Address - City:SANTA CLARITA
Practice Address - State:CA
Practice Address - Zip Code:91350-3719
Practice Address - Country:US
Practice Address - Phone:661-513-9265
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC 6793171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist