Healthcare Provider Details

I. General information

NPI: 1942271663
Provider Name (Legal Business Name): LI & LIAO OPTOMETRY PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/30/2006
Last Update Date: 01/25/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1002 WIBLE RD SUITE I
BAKERSFIELD CA
93304-4137
US

IV. Provider business mailing address

1002 WIBLE RD SUITE I
BAKERSFIELD CA
93304-4137
US

V. Phone/Fax

Practice location:
  • Phone: 661-835-1104
  • Fax: 661-835-8644
Mailing address:
  • Phone: 661-835-1104
  • Fax: 661-835-8644

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number1127
License Number StateCA

VIII. Authorized Official

Name: DR. DAWSON TO-SANG LI
Title or Position: PRESIDENT / OPTOMETRIST
Credential: O.D.
Phone: 661-835-1104