MEDICARE: LAWRENCE LIU

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	225100000X	Physical Therapist	38426	CA

General Provider Information

NPI Number	:	1477827517
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAWRENCE LIU

Provider Business Mailing Address
First Line	:	1500 ROSECRANS AVE
Second Line	:	STE 550
City	:	MANHATTAN BEACH
State	:	CA
Zip	:	90266-3763
Country	:	US
Telephone Number	:	310-643-9401
Fax Number	:	310-643-9410

Provider Business Practice Location Address
First Line	:	1500 ROSECRANS AVE
Second Line	:	STE 550
City	:	MANHATTAN BEACH
State	:	CA
Zip	:	90266-3763
Country	:	US
Telephone Number	:	310-643-9401
Fax Number	:	310-643-9410

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

Provider Enumeration Date	:	03/07/2012
Last Update Date	:	03/07/2012

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Directions to “ LAWRENCE LIU ” Practice Location

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