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NPI Code Detail

MEDICARE: HANNA LIU M.D.

MEDICARE: HANNA LIU M.D.
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
12085R0202XDiagnostic Radiology PhysicianA152556CA

General Provider Information

NPI Number : 1255795092
Entity Type Code : Individual
Provider Name (Legal Business Name) : HANNA LIU M.D.
Provider Business Mailing Address
First Line : 5767 W CENTURY BLVD STE 400
Second Line :
City : LOS ANGELES
State : CA
Zip : 90045-5631
Country : US
Telephone Number : 310-301-5138
Fax Number :
Provider Business Practice Location Address
First Line : 757 WESTWOOD PLZ
Second Line :
City : LOS ANGELES
State : CA
Zip : 90095-2994
Country : US
Telephone Number : 310-301-6800
Fax Number : 310-794-9035
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/07/2016
Last Update Date : 01/13/2023

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