Provider Demographics
NPI:1659687044
Name:LI, MING (DC)
Entity Type:Individual
Prefix:
First Name:MING
Middle Name:
Last Name:LI
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21613 STEVENS CREEK BLVD.
Mailing Address - Street 2:
Mailing Address - City:CUPERTINO
Mailing Address - State:CA
Mailing Address - Zip Code:95014
Mailing Address - Country:US
Mailing Address - Phone:408-255-5018
Mailing Address - Fax:
Practice Address - Street 1:21613 STEVENS CREEK BLVD
Practice Address - Street 2:
Practice Address - City:CUPERTINO
Practice Address - State:CA
Practice Address - Zip Code:95014-1167
Practice Address - Country:US
Practice Address - Phone:408-255-5018
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-24
Last Update Date:2021-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA16080171100000X
CA31741111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
No111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA31741OtherCHIROPRACTOR
CA16080OtherACUPUNCTURE