Provider Demographics
NPI:1548397680
Name:TIU, KAI FONG (LAC)
Entity Type:Individual
Prefix:MR
First Name:KAI
Middle Name:FONG
Last Name:TIU
Suffix:
Gender:M
Credentials:LAC
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Mailing Address - Street 1:20308 VIA THOMAS DR
Mailing Address - Street 2:
Mailing Address - City:WALNUT
Mailing Address - State:CA
Mailing Address - Zip Code:91789-2453
Mailing Address - Country:US
Mailing Address - Phone:909-594-6467
Mailing Address - Fax:909-594-6467
Practice Address - Street 1:1661 HANOVER RD
Practice Address - Street 2:SUITE 103
Practice Address - City:CITY OF INDUSTRY
Practice Address - State:CA
Practice Address - Zip Code:91748-1796
Practice Address - Country:US
Practice Address - Phone:626-913-9868
Practice Address - Fax:909-594-6467
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAAC4495171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist