Provider Demographics
NPI:1528784527
Name:LIU, HAO (LAC)
Entity type:Individual
Prefix:MR
First Name:HAO
Middle Name:
Last Name:LIU
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 CHADBOURNE AVE APT 2
Mailing Address - Street 2:
Mailing Address - City:MILLBRAE
Mailing Address - State:CA
Mailing Address - Zip Code:94030-2556
Mailing Address - Country:US
Mailing Address - Phone:650-302-8080
Mailing Address - Fax:
Practice Address - Street 1:105 CHADBOURNE AVE APT 2
Practice Address - Street 2:
Practice Address - City:MILLBRAE
Practice Address - State:CA
Practice Address - Zip Code:94030-2556
Practice Address - Country:US
Practice Address - Phone:650-302-8080
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-12
Last Update Date:2022-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA19557171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist