Provider Demographics
NPI:1366192213
Name:TAING, LILLY
Entity type:Individual
Prefix:
First Name:LILLY
Middle Name:
Last Name:TAING
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 1:20232 PASEO GRANADA
Mailing Address - Street 2:
Mailing Address - City:CERRITOS
Mailing Address - State:CA
Mailing Address - Zip Code:90703-7649
Mailing Address - Country:US
Mailing Address - Phone:562-229-8489
Mailing Address - Fax:
Practice Address - Street 1:27303 SLEEPY HOLLOW AVE S
Practice Address - Street 2:
Practice Address - City:HAYWARD
Practice Address - State:CA
Practice Address - Zip Code:94545-4203
Practice Address - Country:US
Practice Address - Phone:151-045-4100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-24
Last Update Date:2025-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA203492208000000X
WAML61290618208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics