Provider Demographics
NPI:1649349382
Name:LIU, MARVIN (MA MS LAC)
Entity type:Individual
Prefix:MR
First Name:MARVIN
Middle Name:
Last Name:LIU
Suffix:
Gender:M
Credentials:MA MS LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16200 E AMBER VALLEY DRIVE
Mailing Address - Street 2:
Mailing Address - City:WHITTIER
Mailing Address - State:CA
Mailing Address - Zip Code:90604
Mailing Address - Country:US
Mailing Address - Phone:562-947-8755
Mailing Address - Fax:562-902-3332
Practice Address - Street 1:16200 E AMBER VALLEY DRIVE
Practice Address - Street 2:
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90604
Practice Address - Country:US
Practice Address - Phone:562-943-7125
Practice Address - Fax:562-902-3398
Is Sole Proprietor?:No
Enumeration Date:2006-11-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC10200171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist