Healthcare Provider Details

I. General information

NPI: 1346852258
Provider Name (Legal Business Name): ZIXIAO LIU
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/21/2020
Last Update Date: 08/21/2020
Certification Date: 08/21/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8500 MELROSE AVE STE 210
WEST HOLLYWOOD CA
90069-5169
US

IV. Provider business mailing address

656 S RIDGELEY DR APT 408
LOS ANGELES CA
90036-3842
US

V. Phone/Fax

Practice location:
  • Phone: 310-927-3097
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number18742
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: