Healthcare Provider Details

I. General information

NPI: 1609945633
Provider Name (Legal Business Name): LILLIAN L HUANG L.AC., O.M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/06/2006
Last Update Date: 11/27/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1025 B ST
HAYWARD CA
94541-4107
US

IV. Provider business mailing address

1025 B ST
HAYWARD CA
94541-4107
US

V. Phone/Fax

Practice location:
  • Phone: 510-733-0288
  • Fax: 510-733-6273
Mailing address:
  • Phone: 510-733-0288
  • Fax: 510-733-6273

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC5587
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: