Provider Demographics
NPI:1871507814
Name:LIU, JIANGHUA (LAC)
Entity Type:Individual
Prefix:DR
First Name:JIANGHUA
Middle Name:
Last Name:LIU
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:WILLOW
Other - Middle Name:
Other - Last Name:LIU
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:680 BREA CANYON RD STE 158
Mailing Address - Street 2:
Mailing Address - City:DIAMOND BAR
Mailing Address - State:CA
Mailing Address - Zip Code:91789-3005
Mailing Address - Country:US
Mailing Address - Phone:909-869-1999
Mailing Address - Fax:
Practice Address - Street 1:680 BREA CANYON RD STE 158
Practice Address - Street 2:
Practice Address - City:DIAMOND BAR
Practice Address - State:CA
Practice Address - Zip Code:91789-3005
Practice Address - Country:US
Practice Address - Phone:909-869-1999
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2020-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC 10885171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist