Provider Demographics
NPI:1649048521
Name:LIANG, YUANRUI (LAC)
Entity type:Individual
Prefix:
First Name:YUANRUI
Middle Name:
Last Name:LIANG
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:527 GARDEN AVE
Mailing Address - Street 2:
Mailing Address - City:POMONA
Mailing Address - State:CA
Mailing Address - Zip Code:91767-2277
Mailing Address - Country:US
Mailing Address - Phone:626-223-9932
Mailing Address - Fax:
Practice Address - Street 1:510 N 13TH AVE STE 104
Practice Address - Street 2:
Practice Address - City:UPLAND
Practice Address - State:CA
Practice Address - Zip Code:91786-4973
Practice Address - Country:US
Practice Address - Phone:909-345-1860
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-19
Last Update Date:2023-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA19878171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist