Provider Demographics
NPI:1245442797
Name:LI, HONGMEI JANE (OMD)
Entity type:Individual
Prefix:DR
First Name:HONGMEI
Middle Name:JANE
Last Name:LI
Suffix:
Gender:F
Credentials:OMD
Other - Prefix:
Other - First Name:JANE
Other - Middle Name:
Other - Last Name:LI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OMD
Mailing Address - Street 1:215 S RAMPART BLVD
Mailing Address - Street 2:SUITE 8
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90057-1471
Mailing Address - Country:US
Mailing Address - Phone:310-409-8791
Mailing Address - Fax:818-609-7288
Practice Address - Street 1:6200 WILSHIRE BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90048-5801
Practice Address - Country:US
Practice Address - Phone:323-933-1112
Practice Address - Fax:323-933-9994
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-05
Last Update Date:2008-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC 11064171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist