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General NPI Number Information
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NPI Number | 1699010330
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Entity Type | Individual
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Provider Name | JINGYI LIAO L.AC
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Gender | Female
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Dates
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Enumeration Date | 12/06/2012
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Last Update Date | 12/06/2012
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Provider Practice Location Address
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Address Line | 10 CONGRESS ST STE 310
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City | PASADENA
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State | CA
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Zip | 91105-3084
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Country | US
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Telephone | 626-578-9911
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Fax | 626-626-7978
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Provider Business Mailing Address
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Address Line | 10 CONGRESS ST STE 310
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City | PASADENA
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State | CA
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Zip | 91105-3084
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Country | US
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Telephone | 626-578-9911
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Fax | 626-626-7978
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | AC14754
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License Number State | CA
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