Provider Demographics
NPI:1831345933
Name:LIU, DANTIAN TING (LAC)
Entity type:Individual
Prefix:
First Name:DANTIAN
Middle Name:TING
Last Name:LIU
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:DAN TING
Other - Middle Name:
Other - Last Name:LIU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4521 CAMPUS DR STE 386
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92612-2621
Mailing Address - Country:US
Mailing Address - Phone:949-444-5128
Mailing Address - Fax:
Practice Address - Street 1:18818 TELLER AVE STE 115
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92612-1623
Practice Address - Country:US
Practice Address - Phone:949-444-5128
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-08
Last Update Date:2024-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC11888171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist