Provider Demographics
NPI:1932469244
Name:LIU, MANN YNG
Entity Type:Individual
Prefix:
First Name:MANN
Middle Name:YNG
Last Name:LIU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:180 NORTH 4TH ST.
Mailing Address - Street 2:APT. #601
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95112
Mailing Address - Country:US
Mailing Address - Phone:408-275-8802
Mailing Address - Fax:408-275-8802
Practice Address - Street 1:180 NORTH 4TH ST.
Practice Address - Street 2:APT. #601
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95112
Practice Address - Country:US
Practice Address - Phone:408-275-8802
Practice Address - Fax:408-275-8802
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-21
Last Update Date:2012-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA14608171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist