Healthcare Provider Details

I. General information

NPI: 1336028729
Provider Name (Legal Business Name): MEI LI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/29/2025
Last Update Date: 08/29/2025
Certification Date: 08/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20356 BARNARD AVE
WALNUT CA
91789-2468
US

IV. Provider business mailing address

20356 BARNARD AVE
WALNUT CA
91789-2468
US

V. Phone/Fax

Practice location:
  • Phone: 626-803-7603
  • Fax:
Mailing address:
  • Phone: 626-803-7603
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number84444
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: