Provider Demographics
NPI:1588856371
Name:LI, JIZE
Entity Type:Individual
Prefix:MR
First Name:JIZE
Middle Name:
Last Name:LI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24218 HAWTHORNE BLVD
Mailing Address - Street 2:#4
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90505-6505
Mailing Address - Country:US
Mailing Address - Phone:310-378-5698
Mailing Address - Fax:310-378-5698
Practice Address - Street 1:24218 HAWTHORNE BLVD
Practice Address - Street 2:#4
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-6505
Practice Address - Country:US
Practice Address - Phone:310-378-5698
Practice Address - Fax:310-378-5698
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-15
Last Update Date:2007-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALAC 0038630171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist