Provider Demographics
NPI:1053285510
Name:LIAO, JAKE CHAOPING (LAC)
Entity type:Individual
Prefix:MR
First Name:JAKE
Middle Name:CHAOPING
Last Name:LIAO
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 PONCETTA DR APT 323
Mailing Address - Street 2:
Mailing Address - City:DALY CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94015-4821
Mailing Address - Country:US
Mailing Address - Phone:510-213-3617
Mailing Address - Fax:
Practice Address - Street 1:320 10TH ST STE 228
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94607-6520
Practice Address - Country:US
Practice Address - Phone:510-213-3617
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-30
Last Update Date:2025-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC19489171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty