Healthcare Provider Details

I. General information

NPI: 1821180019
Provider Name (Legal Business Name): LIU AND WANG MEDICAL CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/28/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1118 S GARFIELD AVE 201
ALHAMBRA CA
91801-4713
US

IV. Provider business mailing address

1118 S GARFIELD AVE 201
ALHAMBRA CA
91801-4713
US

V. Phone/Fax

Practice location:
  • Phone: 626-281-0090
  • Fax:
Mailing address:
  • Phone: 626-281-0090
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number StateCA

VIII. Authorized Official

Name: MARY WANG
Title or Position: MANAGER
Credential: MD
Phone: 626-281-0090