Healthcare Provider Details

I. General information

NPI: 1235828047
Provider Name (Legal Business Name): HEIDI ZIJUN LIANG
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/08/2023
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14335 PIPELINE AVE STE A-1
CHINO CA
91710-5642
US

IV. Provider business mailing address

14335 PIPELINE AVE STE A-1
CHINO CA
91710-5642
US

V. Phone/Fax

Practice location:
  • Phone: 909-548-3888
  • Fax: 909-548-3999
Mailing address:
  • Phone: 909-548-3888
  • Fax: 909-548-3999

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: