Healthcare Provider Details

I. General information

NPI: 1801972336
Provider Name (Legal Business Name): XIAOYUAN LIU MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/27/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1725 EASTSHORE HWY
BERKELEY CA
94710-1798
US

IV. Provider business mailing address

1725 EASTSHORE HWY
BERKELEY CA
94710-1798
US

V. Phone/Fax

Practice location:
  • Phone: 510-559-4741
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZP0101X
TaxonomyAnatomic Pathology Physician
License NumberA73627
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: