Healthcare Provider Details

I. General information

NPI: 1770571077
Provider Name (Legal Business Name): AMY LI MATECKI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: YING LI M.D.

II. Dates (important events)

Enumeration Date: 10/11/2005
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3012 SUMMIT ST STE 2675
OAKLAND CA
94609-3480
US

IV. Provider business mailing address

3012 SUMMIT ST STE 2675
OAKLAND CA
94609-3480
US

V. Phone/Fax

Practice location:
  • Phone: 510-869-6740
  • Fax:
Mailing address:
  • Phone: 510-869-6740
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA80747
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number16417
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: