Healthcare Provider Details

I. General information

NPI: 1780430769
Provider Name (Legal Business Name): ATALIE WHITNEY LIU OD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/29/2024
Last Update Date: 06/11/2025
Certification Date: 06/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13111 PEYTON DR
CHINO HILLS CA
91709-6002
US

IV. Provider business mailing address

13111 PEYTON DR
CHINO HILLS CA
91709-6002
US

V. Phone/Fax

Practice location:
  • Phone: 909-628-0091
  • Fax:
Mailing address:
  • Phone: 909-569-9288
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number35983
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: