MEDICARE: YUE LI OMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171100000X	Acupuncturist	AC8520	CA

General Provider Information

NPI Number	:	1184896847
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YUE LI OMD

Provider Business Mailing Address
First Line	:	5182 KATELLA AVE STE 103A
Second Line	:
City	:	LOS ALAMITOS
State	:	CA
Zip	:	90720-2850
Country	:	US
Telephone Number	:	562-936-1980
Fax Number	:	562-936-1981

Provider Business Practice Location Address
First Line	:	5182 KATELLA AVE STE 103A
Second Line	:
City	:	LOS ALAMITOS
State	:	CA
Zip	:	90720-2850
Country	:	US
Telephone Number	:	562-936-1980
Fax Number	:	562-936-1981

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/01/2008
Last Update Date	:	04/01/2008

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Directions to “ YUE LI OMD” Practice Location

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