Healthcare Provider Details

I. General information

NPI: 1881969723
Provider Name (Legal Business Name): JIM K. LIU PHARM-D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/11/2012
Last Update Date: 03/11/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3150 FOSTORIA WAY
DANVILLE CA
94526-5553
US

IV. Provider business mailing address

3150 FOSTORIA WAY
DANVILLE CA
94526-5553
US

V. Phone/Fax

Practice location:
  • Phone: 925-277-1800
  • Fax: 925-277-1839
Mailing address:
  • Phone: 925-277-1800
  • Fax: 925-277-1839

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number32270
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: