Healthcare Provider Details

I. General information

NPI: 1477222149
Provider Name (Legal Business Name): HONG LIU
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/07/2021
Last Update Date: 09/07/2021
Certification Date: 09/07/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2709 RIO SECO DR
BAY POINT CA
94565-7774
US

IV. Provider business mailing address

2709 RIO SECO DR
BAY POINT CA
94565-7774
US

V. Phone/Fax

Practice location:
  • Phone: 925-395-3666
  • Fax:
Mailing address:
  • Phone: 925-395-3666
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number77090
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: