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General NPI Number Information
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NPI Number | 1144414293
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Entity Type | Organization
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Legal Business Name | HEALTHY LIVING PRIMARY CARE, INC
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Dates
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Enumeration Date | 08/31/2007
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Last Update Date | 01/15/2024
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Provider Practice Location Address
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Address Line | 82 CLARKSVILLE RD STE 120
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City | FOLSOM
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State | CA
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Zip | 95630-8210
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Country | US
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Telephone | 916-983-8868
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Fax | 916-983-8891
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Provider Business Mailing Address
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Address Line | 2545 E BIDWELL ST 110
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City | FOLSOM
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State | CA
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Zip | 95630-6440
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Country | US
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Telephone | 916-983-9886
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Fax | 916-983-8891
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JOY LIU
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Credential | D.O.
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Telephone | 916-983-8868
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 20A9350
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License Number State | CA
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