Healthcare Provider Details

I. General information

NPI: 1932211232
Provider Name (Legal Business Name): MING-JAI LIU M.D., PHARM.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 05/10/2025
Certification Date: 05/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1757 E BASELINE RD STE 105
GILBERT AZ
85233-1533
US

IV. Provider business mailing address

PO BOX 72075
PHOENIX AZ
85050-1018
US

V. Phone/Fax

Practice location:
  • Phone: 480-508-2700
  • Fax: 866-371-2839
Mailing address:
  • Phone: 505-228-2306
  • Fax: 505-485-0404

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP6422
License Number StateNM
# 2
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number47701
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: