Healthcare Provider Details

I. General information

NPI: 1518309368
Provider Name (Legal Business Name): MINGHSUN LIU, M.D., PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/22/2013
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11103 VENICE BLVD
LOS ANGELES CA
90034-6914
US

IV. Provider business mailing address

PO BOX 848373
LOS ANGELES CA
90084-8373
US

V. Phone/Fax

Practice location:
  • Phone: 954-923-7440
  • Fax: 954-923-1299
Mailing address:
  • Phone: 954-923-7440
  • Fax: 954-923-1299

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: MINGHSUN LIU
Title or Position: AUTHORIZED OFFICIAL
Credential: MD
Phone: 310-734-8526