Healthcare Provider Details

I. General information

NPI: 1881602548
Provider Name (Legal Business Name): DAVID A LIU PHYSICAL THERAPIST
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/04/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

362 W MISSION AVE
ESCONDIDO CA
92025-1740
US

IV. Provider business mailing address

3214 CARR DR
OCEANSIDE CA
92056-3810
US

V. Phone/Fax

Practice location:
  • Phone: 760-747-2031
  • Fax: 760-747-2875
Mailing address:
  • Phone: 760-747-2031
  • Fax: 760-747-2875

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT 16480
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: