Healthcare Provider Details

I. General information

NPI: 1518768753
Provider Name (Legal Business Name): BARRY LIU
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/24/2025
Last Update Date: 03/24/2025
Certification Date: 03/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

713 W DUARTE RD # G828
ARCADIA CA
91007-7564
US

IV. Provider business mailing address

713 W DUARTE RD # G828
ARCADIA CA
91007-7564
US

V. Phone/Fax

Practice location:
  • Phone: 310-488-2600
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number002571793
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: