Healthcare Provider Details

I. General information

NPI: 1548408412
Provider Name (Legal Business Name): LIEN AI DIEP D.C., L.AC.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/29/2009
Last Update Date: 01/29/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

823 N BROADWAY
LOS ANGELES CA
90012-2309
US

IV. Provider business mailing address

823 N BROADWAY
LOS ANGELES CA
90012-2309
US

V. Phone/Fax

Practice location:
  • Phone: 213-680-1456
  • Fax: 213-680-9385
Mailing address:
  • Phone: 213-680-1456
  • Fax: 213-680-9385

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NN1001X
TaxonomyNutrition Chiropractor
License NumberDC-27668
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC-8379
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: