Healthcare Provider Details

I. General information

NPI: 1679921399
Provider Name (Legal Business Name): LIANE MCAULIFFE M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/03/2016
Last Update Date: 06/03/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

NAVAL MEDICAL CTR 34800 BOB WILSON DRIVE
SAN DIEGO CA
92134-5000
US

IV. Provider business mailing address

NAVAL MEDICAL CTR 34800 BOB WILSON DRIVE
SAN DIEGO CA
92134-5000
US

V. Phone/Fax

Practice location:
  • Phone: 619-532-6827
  • Fax: 619-532-7508
Mailing address:
  • Phone: 619-532-6827
  • Fax: 619-532-7508

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171000000X
TaxonomyMilitary Health Care Provider
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: