Healthcare Provider Details

I. General information

NPI: 1841142890
Provider Name (Legal Business Name): DONGFANG LIAO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/12/2026
Last Update Date: 02/12/2026
Certification Date: 02/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

835 CLAY ST STE 102
SAN FRANCISCO CA
94108-1639
US

IV. Provider business mailing address

34 BRITTON ST
SAN FRANCISCO CA
94134-2733
US

V. Phone/Fax

Practice location:
  • Phone: 415-812-9458
  • Fax:
Mailing address:
  • Phone: 415-812-9458
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: