MEDICARE: DR. IPING LIU DDS

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	1223G0001X	General Practice Dentistry	29231	CA

General Provider Information

NPI Number	:	1497863260
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. IPING LIU DDS

Provider Business Mailing Address
First Line	:	1600 W REDONDO BEACH BLVD
Second Line	:	STE 203
City	:	GARDENA
State	:	CA
Zip	:	90247-3226
Country	:	US
Telephone Number	:	562-864-1011
Fax Number	:	310-808-0198

Provider Business Practice Location Address
First Line	:	1600 W REDONDO BEACH BLVD
Second Line	:	STE 203
City	:	GARDENA
State	:	CA
Zip	:	90247-3226
Country	:	US
Telephone Number	:	562-864-1011
Fax Number	:	310-808-0198

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

Provider Enumeration Date	:	08/29/2006
Last Update Date	:	10/22/2013

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