Provider Demographics
NPI:1134154347
Name:LIANG, STEPHANIE JOYCE (DC)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:JOYCE
Last Name:LIANG
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11301 W OLYMPIC BLVD STE 121-631
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90064-1653
Mailing Address - Country:US
Mailing Address - Phone:310-213-5757
Mailing Address - Fax:310-439-2212
Practice Address - Street 1:11301 W OLYMPIC BLVD STE 121-631
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90064-1653
Practice Address - Country:US
Practice Address - Phone:310-213-5757
Practice Address - Fax:310-439-2212
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-12
Last Update Date:2018-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC26430111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC26430Medicare ID - Type Unspecified
CAV06954Medicare UPIN