Healthcare Provider Details

I. General information

NPI: 1962336321
Provider Name (Legal Business Name): XIAO LI
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/10/2026
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10430 S DE ANZA BLVD STE 230A
CUPERTINO CA
95014-3019
US

IV. Provider business mailing address

10430 S DE ANZA BLVD STE 230A
CUPERTINO CA
95014-3019
US

V. Phone/Fax

Practice location:
  • Phone: 415-816-8569
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: