Healthcare Provider Details

I. General information

NPI: 1902173867
Provider Name (Legal Business Name): SHUXIAN LIU L.AC.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/21/2011
Last Update Date: 11/21/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3031 TISCH WAY STE 5PW
SAN JOSE CA
95128-2530
US

IV. Provider business mailing address

4911 PONY PASS CIR
SAN JOSE CA
95136
US

V. Phone/Fax

Practice location:
  • Phone: 408-260-8868
  • Fax: 408-260-8889
Mailing address:
  • Phone: 510-695-1982
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC14495
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: