Provider Demographics
NPI:1841312766
Name:LI, JIAHUI (OMD)
Entity type:Individual
Prefix:DR
First Name:JIAHUI
Middle Name:
Last Name:LI
Suffix:
Gender:F
Credentials:OMD
Other - Prefix:DR
Other - First Name:HELENA
Other - Middle Name:
Other - Last Name:LEE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OMD
Mailing Address - Street 1:409 S NEW AVE UNIT B
Mailing Address - Street 2:
Mailing Address - City:MONTEREY PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91755-3503
Mailing Address - Country:US
Mailing Address - Phone:626-572-9818
Mailing Address - Fax:626-573-5389
Practice Address - Street 1:409 S NEW AVE UNIT B
Practice Address - Street 2:
Practice Address - City:MONTEREY PARK
Practice Address - State:CA
Practice Address - Zip Code:91755-3503
Practice Address - Country:US
Practice Address - Phone:626-572-9818
Practice Address - Fax:626-573-5389
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC3630171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist