MEDICARE: MR. ERIC LIU I M.P.T.

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	PT18982	CA

General Provider Information

NPI Number	:	1710066246
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ERIC LIU I M.P.T.

Provider Business Mailing Address
First Line	:	3575 E CALIFORNIA BLVD
Second Line	:
City	:	PASADENA
State	:	CA
Zip	:	91107-5666
Country	:	US
Telephone Number	:	626-795-4095
Fax Number	:

Provider Business Practice Location Address
First Line	:	9627 LAS TUNAS DR
Second Line	:
City	:	TEMPLE CITY
State	:	CA
Zip	:	91780-2109
Country	:	US
Telephone Number	:	626-292-1793
Fax Number	:

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

Provider Enumeration Date	:	11/03/2006
Last Update Date	:	07/08/2007

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