Healthcare Provider Details

I. General information

NPI: 1568611549
Provider Name (Legal Business Name): AIHONG LIU M.D., PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/15/2008
Last Update Date: 12/06/2021
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4867 W SUNSET BLVD PATHOLOGY DEPARTMENT
LOS ANGELES CA
90027-5969
US

IV. Provider business mailing address

4867 W SUNSET BLVD
LOS ANGELES CA
90027-5969
US

V. Phone/Fax

Practice location:
  • Phone: 323-783-0298
  • Fax: 323-783-7825
Mailing address:
  • Phone: 323-783-0298
  • Fax: 323-783-7825

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZH0000X
TaxonomyHematology (Pathology) Physician
License NumberA110490
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License NumberA110490
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: