MEDICARE: TOMMY LIUNG

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	PA67441	CA

General Provider Information

NPI Number	:	1104668292
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TOMMY LIUNG

Provider Business Mailing Address
First Line	:	11625 HALLWOOD DR
Second Line	:
City	:	EL MONTE
State	:	CA
Zip	:	91732-1435
Country	:	US
Telephone Number	:	626-677-6129
Fax Number	:

Provider Business Practice Location Address
First Line	:	2409 S VERMONT AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90007-1661
Country	:	US
Telephone Number	:	323-730-1663
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/10/2024
Last Update Date	:	01/21/2026

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Directions to “ TOMMY LIUNG ” Practice Location

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