Healthcare Provider Details

I. General information

NPI: 1306080098
Provider Name (Legal Business Name): DR. ANNA LIU, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/24/2009
Last Update Date: 07/08/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11100 WARNER AVE 358
FOUNTAIN VALLEY CA
92708-7506
US

IV. Provider business mailing address

11100 WARNER AVE 358
FOUNTAIN VALLEY CA
92708-7506
US

V. Phone/Fax

Practice location:
  • Phone: 714-966-1500
  • Fax:
Mailing address:
  • Phone: 714-966-1500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number009417
License Number StateCA

VIII. Authorized Official

Name: ANNA LIU
Title or Position: DOCTOR/OWNER
Credential: D.O.
Phone: 714-350-2754