=====================================================
General NPI Number Information
=====================================================
NPI Number | 1962729228
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | HONGYAN LI
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/27/2010
-----------------------------------------------------
Last Update Date | 11/05/2015
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5150 GRAVES AVE SUITE 5A
-----------------------------------------------------
City | SAN JOSE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95129-5013
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 408-676-6371
-----------------------------------------------------
Fax | 408-228-0731
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 781 CASCADE DR
-----------------------------------------------------
City | SUNNYVALE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 94087-3158
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 408-676-6371
-----------------------------------------------------
Fax | 408-228-0731
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 171100000X
-----------------------------------------------------
Taxonomy Name | Acupuncturist
-----------------------------------------------------
License Number | 13447
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------