Provider Demographics
NPI:1558437517
Name:LI, NING
Entity Type:Individual
Prefix:
First Name:NING
Middle Name:
Last Name:LI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:NANCY
Other - Middle Name:
Other - Last Name:LI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:23457 AMBERWICK PL
Mailing Address - Street 2:
Mailing Address - City:DIAMOND BAR
Mailing Address - State:CA
Mailing Address - Zip Code:91765-2604
Mailing Address - Country:US
Mailing Address - Phone:626-378-8888
Mailing Address - Fax:909-860-3920
Practice Address - Street 1:500 N GARFIELD AVE
Practice Address - Street 2:#201
Practice Address - City:MONTEREY PARK
Practice Address - State:CA
Practice Address - Zip Code:91754-1242
Practice Address - Country:US
Practice Address - Phone:626-571-7115
Practice Address - Fax:909-860-3920
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-28
Last Update Date:2010-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC6715171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist