MEDICARE: ANGIE LI

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	16923	CA

General Provider Information

NPI Number	:	1952761462
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANGIE LI

Provider Business Mailing Address
First Line	:	1308 S NEW HAMPSHIRE AVE
Second Line	:	#406
City	:	LOS ANGELES
State	:	CA
Zip	:	90006-4552
Country	:	US
Telephone Number	:	213-392-2005
Fax Number	:

Provider Business Practice Location Address
First Line	:	1308 S NEW HAMPSHIRE AVE
Second Line	:	#406
City	:	LOS ANGELES
State	:	CA
Zip	:	90006-4552
Country	:	US
Telephone Number	:	213-392-2005
Fax Number	:

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

Provider Enumeration Date	:	02/25/2016
Last Update Date	:	02/25/2016

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Directions to “ ANGIE LI ” Practice Location

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