Healthcare Provider Details

I. General information

NPI: 1538419510
Provider Name (Legal Business Name): KAIRONG LI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KAREN LI

II. Dates (important events)

Enumeration Date: 09/17/2012
Last Update Date: 06/23/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2700 N BELLFLOWER BLVD STE 116 ACUPUNCTURE FOR USA
LONG BEACH CA
90815-1100
US

IV. Provider business mailing address

2700 N BELLFLOWER BLVD STE 116
LONG BEACH CA
90815-1100
US

V. Phone/Fax

Practice location:
  • Phone: 562-888-3399
  • Fax: 562-567-7881
Mailing address:
  • Phone: 562-888-3399
  • Fax: 562-567-7881

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC14613
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: