Provider Demographics
NPI:1972657849
Name:LI, ANNA WEI
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:WEI
Last Name:LI
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 1:608 E FREMONT AVE
Mailing Address - Street 2:
Mailing Address - City:SUNNYVALE
Mailing Address - State:CA
Mailing Address - Zip Code:94087-3401
Mailing Address - Country:US
Mailing Address - Phone:408-394-2440
Mailing Address - Fax:408-245-4958
Practice Address - Street 1:2500 HOSPITAL DR
Practice Address - Street 2:BLDG 11 UNIT C
Practice Address - City:MOUNTAIN VIEW
Practice Address - State:CA
Practice Address - Zip Code:94040-1180
Practice Address - Country:US
Practice Address - Phone:408-394-2440
Practice Address - Fax:408-245-4958
Is Sole Proprietor?:No
Enumeration Date:2007-01-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC9594171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAAC0095940Medicaid
CAAC0095940Medicaid