=====================================================
General NPI Number Information
=====================================================
NPI Number | 1568670677
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | WEIQING LI SEAMONE L.A.C
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/21/2007
-----------------------------------------------------
Last Update Date | 07/08/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2520 HONOLULU AVE STE 175
-----------------------------------------------------
City | MONTROSE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91020-1895
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 818-236-3631
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 93442
-----------------------------------------------------
City | CITY OF INDUSTRY
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91715-3442
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 171100000X
-----------------------------------------------------
Taxonomy Name | Acupuncturist
-----------------------------------------------------
License Number | CA10328
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------