Healthcare Provider Details

I. General information

NPI: 1831345933
Provider Name (Legal Business Name): DANTIAN TING LIU L.AC.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: DAN TING LIU

II. Dates (important events)

Enumeration Date: 08/08/2008
Last Update Date: 12/05/2024
Certification Date: 12/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18818 TELLER AVE STE 115
IRVINE CA
92612-1623
US

IV. Provider business mailing address

4521 CAMPUS DR STE 386
IRVINE CA
92612-2621
US

V. Phone/Fax

Practice location:
  • Phone: 949-444-5128
  • Fax:
Mailing address:
  • Phone: 949-444-5128
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC11888
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: