Provider Demographics
NPI:1558419622
Name:LI, BAOPING (LIC AC, & OMD)
Entity Type:Individual
Prefix:
First Name:BAOPING
Middle Name:
Last Name:LI
Suffix:
Gender:M
Credentials:LIC AC, & OMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1736 PICASSO AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:DAVIS
Mailing Address - State:CA
Mailing Address - Zip Code:95618
Mailing Address - Country:US
Mailing Address - Phone:530-756-8802
Mailing Address - Fax:530-756-8852
Practice Address - Street 1:1736 PICASSO AVE
Practice Address - Street 2:SUITE B
Practice Address - City:DAVIS
Practice Address - State:CA
Practice Address - Zip Code:95618
Practice Address - Country:US
Practice Address - Phone:530-756-8802
Practice Address - Fax:530-756-8852
Is Sole Proprietor?:No
Enumeration Date:2007-01-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC 4959171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist