Healthcare Provider Details

I. General information

NPI: 1689170920
Provider Name (Legal Business Name): MING ZHAO LIU MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/04/2018
Last Update Date: 02/29/2024
Certification Date: 02/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1120 W LA VETA AVE STE 660&470
ORANGE CA
92868-4231
US

IV. Provider business mailing address

1120 W LA VETA AVE STE 660&470
ORANGE CA
92868-4231
US

V. Phone/Fax

Practice location:
  • Phone: 714-509-8210
  • Fax:
Mailing address:
  • Phone: 714-509-8210
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberA166167
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: