| Lis Chiropractic Corp | |
|
21613 Stevens Creek Blvd Cupertino CA 95014-1167 | |
| (408) 255-5018 | |
| (408) 255-2599 |
| Full Name | Lis Chiropractic Corp |
|---|---|
| Speciality | Clinic/Center |
| Location | 21613 Stevens Creek Blvd, Cupertino, California |
| Authorized Official Name and Position | Ming Li (OWNER/DOCTOR) |
| Authorized Official Contact | 4082555018 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lis Chiropractic Corp 21613 Stevens Creek Blvd Cupertino CA 95014-1167 Ph: (408) 255-5018 | Lis Chiropractic Corp 21613 Stevens Creek Blvd Cupertino CA 95014-1167 Ph: (408) 255-5018 |
| NPI Number | 1750806857 |
|---|---|
| Provider Enumeration Date | 08/09/2017 |
| Last Update Date | 11/15/2022 |
| Certification Date | 11/15/2022 |
| Medicare PECOS PAC ID | 6608244249 |
|---|---|
| Medicare Enrollment ID | O20221201002257 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750806857 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | () | Primary |
| 111N00000X | Chiropractor | 31741 (California) | Secondary |
| 171100000X | Acupuncturist | 16080 (California) | Secondary |
| Provider Name | Ming Li |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1659687044 PECOS PAC ID: 7416142146 Enrollment ID: I20101108001234 |
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