Provider Demographics
NPI:1366102097
Name:L-A ACUPUNCTURE CLINIC
Entity type:Organization
Organization Name:L-A ACUPUNCTURE CLINIC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LINGYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:LIU
Authorized Official - Suffix:
Authorized Official - Credentials:L AC
Authorized Official - Phone:650-769-0860
Mailing Address - Street 1:15466 LOS GATOS BLVD STE 214
Mailing Address - Street 2:
Mailing Address - City:LOS GATOS
Mailing Address - State:CA
Mailing Address - Zip Code:95032-2551
Mailing Address - Country:US
Mailing Address - Phone:650-769-0860
Mailing Address - Fax:888-281-3073
Practice Address - Street 1:15466 LOS GATOS BLVD STE 214
Practice Address - Street 2:
Practice Address - City:LOS GATOS
Practice Address - State:CA
Practice Address - Zip Code:95032-2551
Practice Address - Country:US
Practice Address - Phone:650-769-0860
Practice Address - Fax:888-281-3073
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-21
Last Update Date:2022-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty