Provider Demographics
NPI:1295057594
Name:MENG, LI
Entity type:Individual
Prefix:
First Name:LI
Middle Name:
Last Name:MENG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2905 HOMESTEAD RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:SANTA CLARA
Mailing Address - State:CA
Mailing Address - Zip Code:95051-5476
Mailing Address - Country:US
Mailing Address - Phone:408-459-3767
Mailing Address - Fax:
Practice Address - Street 1:2905 HOMESTEAD RD
Practice Address - Street 2:SUITE B
Practice Address - City:SANTA CLARA
Practice Address - State:CA
Practice Address - Zip Code:95051-5476
Practice Address - Country:US
Practice Address - Phone:408-459-3767
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-28
Last Update Date:2012-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC 13272171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist