Provider Demographics
NPI:1962112425
Name:LI, TIAN CHIN (MSOM; LAC)
Entity type:Individual
Prefix:MR
First Name:TIAN CHIN
Middle Name:
Last Name:LI
Suffix:
Gender:M
Credentials:MSOM; LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:709 N HILL ST STE 11
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90012-2352
Mailing Address - Country:US
Mailing Address - Phone:626-766-6698
Mailing Address - Fax:
Practice Address - Street 1:709 N HILL ST STE 11
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90012-2352
Practice Address - Country:US
Practice Address - Phone:626-766-6698
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-24
Last Update Date:2022-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA19354171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist