Provider Demographics
NPI:1487737862
Name:LIU, DAVE D (ACUPUNCTURIST)
Entity type:Individual
Prefix:DR
First Name:DAVE
Middle Name:D
Last Name:LIU
Suffix:
Gender:M
Credentials:ACUPUNCTURIST
Other - Prefix:
Other - First Name:DAHE
Other - Middle Name:
Other - Last Name:LIU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ACUPUNCTURIST
Mailing Address - Street 1:2306 TARAVAL ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94116-2252
Mailing Address - Country:US
Mailing Address - Phone:415-753-3418
Mailing Address - Fax:415-753-8428
Practice Address - Street 1:2306 TARAVAL ST
Practice Address - Street 2:SUITE 101
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94116-2252
Practice Address - Country:US
Practice Address - Phone:415-753-3418
Practice Address - Fax:415-753-8428
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC0034010171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAAC0034010Medicaid