Healthcare Provider Details

I. General information

NPI: 1447836358
Provider Name (Legal Business Name): VICTORIA LIEW DPM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/22/2021
Last Update Date: 08/20/2025
Certification Date: 08/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1524 MCHENRY AVE STE 300
MODESTO CA
95350-4570
US

IV. Provider business mailing address

1524 MCHENRY AVE STE 300
MODESTO CA
95350-4570
US

V. Phone/Fax

Practice location:
  • Phone: 209-722-4842
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberE5997
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: