Healthcare Provider Details

I. General information

NPI: 1689123879
Provider Name (Legal Business Name): LIAM GHIAM MD, MS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: ALIREZA GHIAM MD, MS

II. Dates (important events)

Enumeration Date: 09/28/2016
Last Update Date: 07/10/2025
Certification Date: 07/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3951 KATELLA AVE STE 102
LOS ALAMITOS CA
90720-3303
US

IV. Provider business mailing address

3951 KATELLA AVE STE 102
LOS ALAMITOS CA
90720-3303
US

V. Phone/Fax

Practice location:
  • Phone: 562-799-3198
  • Fax: 562-799-3509
Mailing address:
  • Phone: 562-799-3198
  • Fax: 562-799-3509

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License NumberA165739
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: