Healthcare Provider Details

I. General information

NPI: 1124932942
Provider Name (Legal Business Name): KEVIN LIU
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/29/2026
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

702 MARSHALL ST STE 100
REDWOOD CITY CA
94063-2185
US

IV. Provider business mailing address

702 MARSHALL ST STE 100
REDWOOD CITY CA
94063-2185
US

V. Phone/Fax

Practice location:
  • Phone: 650-299-2977
  • Fax:
Mailing address:
  • Phone: 650-299-2977
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number4235
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: