Healthcare Provider Details

I. General information

NPI: 1164099487
Provider Name (Legal Business Name): ANNE LIAO MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/06/2021
Last Update Date: 09/02/2025
Certification Date: 09/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

253 S DIAMOND BAR BLVD
DIAMOND BAR CA
91765-1606
US

IV. Provider business mailing address

1720 E CESAR E CHAVEZ AVE
LOS ANGELES CA
90033-2414
US

V. Phone/Fax

Practice location:
  • Phone: 909-860-1144
  • Fax:
Mailing address:
  • Phone: 323-260-5781
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberA193649
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: