Healthcare Provider Details

I. General information

NPI: 1073451886
Provider Name (Legal Business Name): BIOTIC LIVING, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/23/2026
Last Update Date: 03/23/2026
Certification Date: 03/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

806 S 1ST AVE
ARCADIA CA
91006-3917
US

IV. Provider business mailing address

806 S 1ST AVE
ARCADIA CA
91006-3917
US

V. Phone/Fax

Practice location:
  • Phone: 626-683-3712
  • Fax: 626-377-4221
Mailing address:
  • Phone: 626-683-3712
  • Fax: 626-377-4221

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: TOM WU
Title or Position: PRESIDENT
Credential:
Phone: 626-683-3712