Healthcare Provider Details

I. General information

NPI: 1215346358
Provider Name (Legal Business Name): YEN PO LIU FOOT SPECIALIST INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/02/2014
Last Update Date: 03/15/2024
Certification Date: 03/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

420 N GARFIELD AVE STE 206
MONTEREY PARK CA
91754-1206
US

IV. Provider business mailing address

420 N GARFIELD AVE STE 206
MONTEREY PARK CA
91754-1206
US

V. Phone/Fax

Practice location:
  • Phone: 626-572-8950
  • Fax: 626-415-6229
Mailing address:
  • Phone: 626-375-7558
  • Fax: 626-415-6229

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0131X
TaxonomyFoot Surgery Podiatrist
License NumberE4832
License Number StateCA

VIII. Authorized Official

Name: MR. YEN PO LIU
Title or Position: CEO
Credential: DPM
Phone: 626-376-8720