Provider Demographics
NPI:1942692454
Name:LIAO, COREY WEIHUA (LAC)
Entity Type:Individual
Prefix:MS
First Name:COREY
Middle Name:WEIHUA
Last Name:LIAO
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19041 GOLD LN
Mailing Address - Street 2:
Mailing Address - City:WALNUT
Mailing Address - State:CA
Mailing Address - Zip Code:91789-4724
Mailing Address - Country:US
Mailing Address - Phone:626-384-1277
Mailing Address - Fax:
Practice Address - Street 1:1736 LANDAU PL
Practice Address - Street 2:
Practice Address - City:HACIENDA HEIGHTS
Practice Address - State:CA
Practice Address - Zip Code:91745-3762
Practice Address - Country:US
Practice Address - Phone:626-384-1277
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-21
Last Update Date:2015-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA14889171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist