Healthcare Provider Details

I. General information

NPI: 1912017286
Provider Name (Legal Business Name): MING LIU M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/30/2006
Last Update Date: 08/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2485 HOSPITAL DR SUITE 240
MOUNTAIN VIEW CA
94040-4101
US

IV. Provider business mailing address

2485 HOSPITAL DR SUITE 240
MOUNTAIN VIEW CA
94040-4101
US

V. Phone/Fax

Practice location:
  • Phone: 650-962-4555
  • Fax: 650-962-4550
Mailing address:
  • Phone: 650-962-4555
  • Fax: 650-962-4550

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberA056341
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: