Healthcare Provider Details

I. General information

NPI: 1396153060
Provider Name (Legal Business Name): HAO YI LIU DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/25/2014
Last Update Date: 10/05/2025
Certification Date: 10/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

149 N 6TH ST
MONTEBELLO CA
90640-5257
US

IV. Provider business mailing address

5219 SERENO DR
TEMPLE CITY CA
91780-3044
US

V. Phone/Fax

Practice location:
  • Phone: 626-497-6220
  • Fax:
Mailing address:
  • Phone: 626-497-6220
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number63736
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: