Provider Demographics
NPI:1467996686
Name:HEALTHY LIVING PRIMARY CARE, INC
Entity Type:Organization
Organization Name:HEALTHY LIVING PRIMARY CARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:JOY
Authorized Official - Middle Name:
Authorized Official - Last Name:LIU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:916-983-8868
Mailing Address - Street 1:11634 FAIR OAKS BLVD
Mailing Address - Street 2:
Mailing Address - City:FAIR OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:95628-3771
Mailing Address - Country:US
Mailing Address - Phone:916-983-8868
Mailing Address - Fax:916-983-8891
Practice Address - Street 1:11634 FAIR OAKS BLVD
Practice Address - Street 2:
Practice Address - City:FAIR OAKS
Practice Address - State:CA
Practice Address - Zip Code:95628-3771
Practice Address - Country:US
Practice Address - Phone:916-983-8868
Practice Address - Fax:916-983-8891
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-07
Last Update Date:2016-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty