Healthcare Provider Details
I. General information
NPI: 1386226553
Provider Name (Legal Business Name): LIWAY PROFESSIONAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/26/2021
Last Update Date: 07/20/2024
Certification Date: 07/20/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
78 S ROSEMEAD BLVD
PASADENA CA
91107-3959
US
IV. Provider business mailing address
78 S ROSEMEAD BLVD
PASADENA CA
91107-3959
US
V. Phone/Fax
- Phone: 626-838-7038
- Fax:
- Phone: 626-838-7038
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 171100000X |
| Taxonomy | Acupuncturist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
TUNGCHEN
HSIEH
Title or Position: CEO
Credential:
Phone: 626-298-6117