Healthcare Provider Details

I. General information

NPI: 1730090184
Provider Name (Legal Business Name): SHUYA LI
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/15/2026
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6235 RIVER CREST DR
RIVERSIDE CA
92507-0788
US

IV. Provider business mailing address

15392 VERDUN CIR
IRVINE CA
92604-3153
US

V. Phone/Fax

Practice location:
  • Phone: 951-653-7561
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: