Healthcare Provider Details

I. General information

NPI: 1760973937
Provider Name (Legal Business Name): CHE CARRIE LIU MD, MPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/23/2018
Last Update Date: 02/23/2022
Certification Date: 02/23/2022
Deactivation Date: 03/14/2019
Reactivation Date: 04/01/2019

III. Provider practice location address

3838 N CAMPBELL AVE BLDG 2
TUCSON AZ
85719-1454
US

IV. Provider business mailing address

PO BOX 245074
TUCSON AZ
85724-5074
US

V. Phone/Fax

Practice location:
  • Phone: 520-694-8888
  • Fax:
Mailing address:
  • Phone: 520-621-9041
  • Fax: 520-626-6995

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207YP0228X
TaxonomyPediatric Otolaryngology Physician
License Number63425
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: