Healthcare Provider Details

I. General information

NPI: 1346012804
Provider Name (Legal Business Name): MS. YUN-WEI LIU
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/26/2023
Last Update Date: 09/03/2024
Certification Date: 09/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11460 W WASHINGTON BLVD
LOS ANGELES CA
90066-6030
US

IV. Provider business mailing address

2509 W REDONDO BEACH BLVD APT 20
GARDENA CA
90249-4868
US

V. Phone/Fax

Practice location:
  • Phone: 310-337-7115
  • Fax:
Mailing address:
  • Phone: 213-310-6696
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number25609
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: