Provider Demographics
NPI:1336459015
Name:LIU, YI-LING (MSOM, LAC)
Entity Type:Individual
Prefix:
First Name:YI-LING
Middle Name:
Last Name:LIU
Suffix:
Gender:F
Credentials:MSOM, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9342 S. GILBERT ST
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92804
Mailing Address - Country:US
Mailing Address - Phone:714-598-5403
Mailing Address - Fax:
Practice Address - Street 1:9342 S. GILBERT ST
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92804
Practice Address - Country:US
Practice Address - Phone:714-598-5403
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-15
Last Update Date:2010-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC13847171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist