Provider Demographics
NPI:1801033857
Name:LLY ACUPUNCTURE
Entity Type:Organization
Organization Name:LLY ACUPUNCTURE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACUPUNCTURIST
Authorized Official - Prefix:
Authorized Official - First Name:LILY
Authorized Official - Middle Name:DANZHI
Authorized Official - Last Name:LI
Authorized Official - Suffix:
Authorized Official - Credentials:L,AC
Authorized Official - Phone:714-698-2621
Mailing Address - Street 1:7020 TRASK AVE
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CA
Mailing Address - Zip Code:92683-2622
Mailing Address - Country:US
Mailing Address - Phone:714-698-2621
Mailing Address - Fax:714-698-2621
Practice Address - Street 1:7020 TRASK AVE
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CA
Practice Address - Zip Code:92683-2622
Practice Address - Country:US
Practice Address - Phone:714-698-2621
Practice Address - Fax:714-698-2621
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-13
Last Update Date:2009-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC6047171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty