MEDICARE: FU LI LIU LAC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171100000X	Acupuncturist	LAC8309	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	LAC8309	OTHER	CA	ACCUPUNCTURE LIC

General Provider Information

NPI Number	:	1629289996
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FU LI LIU LAC

Provider Business Mailing Address
First Line	:	16028 GALE AVE
Second Line	:
City	:	HACIENDA HEIGHTS
State	:	CA
Zip	:	91745-1605
Country	:	US
Telephone Number	:	626-336-7605
Fax Number	:	626-336-5605

Provider Business Practice Location Address
First Line	:	16028 GALE AVE
Second Line	:
City	:	HACIENDA HEIGHTS
State	:	CA
Zip	:	91745-1605
Country	:	US
Telephone Number	:	626-336-7605
Fax Number	:	626-336-5605

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/25/2007
Last Update Date	:	03/10/2014

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Directions to “ FU LI LIU LAC” Practice Location

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