Healthcare Provider Details

I. General information

NPI: 1780892117
Provider Name (Legal Business Name): HONGGUANG LIU M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/18/2007
Last Update Date: 04/04/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1825 SONOMA ST
REDDING CA
96001-2519
US

IV. Provider business mailing address

1825 SONOMA ST
REDDING CA
96001-2519
US

V. Phone/Fax

Practice location:
  • Phone: 530-338-2406
  • Fax: 530-338-2408
Mailing address:
  • Phone: 530-338-2406
  • Fax: 530-338-2408

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberA120683
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: