Healthcare Provider Details

I. General information

NPI: 1437013364
Provider Name (Legal Business Name): LOI LUONG
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/15/2025
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

831 53RD AVE UNIT B
OAKLAND CA
94601-5637
US

IV. Provider business mailing address

831 53RD AVE UNIT B
OAKLAND CA
94601-5637
US

V. Phone/Fax

Practice location:
  • Phone: 510-696-3690
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number100928
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: