Healthcare Provider Details
I. General information
NPI: 1245319706
Provider Name (Legal Business Name): DR. DAWN LIU CHIROPRACTIC, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/03/2006
Last Update Date: 02/23/2024
Certification Date: 02/23/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
977 LOMAS SANTA FE DR STE D
SOLANA BEACH CA
92075-2134
US
IV. Provider business mailing address
977 LOMAS SANTA FE DR STE D
SOLANA BEACH CA
92075-2134
US
V. Phone/Fax
- Phone: 858-481-1438
- Fax: 858-481-1738
- Phone: 858-481-1438
- Fax: 858-481-1738
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | DC-29169 |
| License Number State | CA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 171100000X |
| Taxonomy | Acupuncturist |
| License Number | AC 9937 |
| License Number State | CA |
VIII. Authorized Official
Name: DR.
DAWN
XIAODONG
LIU
Title or Position: PRESIDENT
Credential: DC, L.AC
Phone: 858-481-1438