Provider Demographics
NPI:1710526603
Name:LI, KEBIN
Entity Type:Individual
Prefix:DR
First Name:KEBIN
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 1:32759 CLEAR LAKE ST
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94555-1012
Mailing Address - Country:US
Mailing Address - Phone:510-552-9431
Mailing Address - Fax:
Practice Address - Street 1:2905 STENDER WAY STE 46
Practice Address - Street 2:
Practice Address - City:SANTA CLARA
Practice Address - State:CA
Practice Address - Zip Code:95054-3224
Practice Address - Country:US
Practice Address - Phone:510-552-9431
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-25
Last Update Date:2019-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist