Healthcare Provider Details

I. General information

NPI: 1861713877
Provider Name (Legal Business Name): LIU'S ACUPUNCTURE CLINIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/14/2010
Last Update Date: 06/14/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

53 CRONIN DR
SANTA CLARA CA
95051-6719
US

IV. Provider business mailing address

53 CRONIN DR
SANTA CLARA CA
95051-6719
US

V. Phone/Fax

Practice location:
  • Phone: 408-984-2455
  • Fax: 408-984-2456
Mailing address:
  • Phone: 408-984-2455
  • Fax: 408-984-2456

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MR. DAMON CHARLES FRACH
Title or Position: OFFICE MANAGER
Credential: PHD
Phone: 408-984-2455