Healthcare Provider Details

I. General information

NPI: 1619336336
Provider Name (Legal Business Name): STEVE J LIU AU.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/23/2016
Last Update Date: 02/23/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19582 BEACH BLVD STE 110
HUNTINGTON BEACH CA
92648-2996
US

IV. Provider business mailing address

19582 BEACH BLVD STE 110
HUNTINGTON BEACH CA
92648-2996
US

V. Phone/Fax

Practice location:
  • Phone: 714-602-2790
  • Fax: 714-602-2791
Mailing address:
  • Phone: 714-602-2790
  • Fax: 714-602-2791

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberAU3114
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: