Organization
LIVEFREELY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANIEL JUE (CO-OWNER)
(408) 981-5577
Entity
Organization
Contact information
Practice address
4820 HARWOOD RD STE 200, SAN JOSE, CA 95124-5273
(408) 981-5577
Mailing address
167 BANGOR AVE, SAN JOSE, CA 95123-3602
(408) 981-5577
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A4757579
DRIVERS LICENSE
CA
Enumeration date
07/01/2021
Last updated
07/01/2021
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