Healthcare Provider Details

I. General information

NPI: 1659627545
Provider Name (Legal Business Name): HARRISON LIU PHARM.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2012
Last Update Date: 04/22/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24900 HIGHWAY 202
TEHACHAPI CA
93561-5558
US

IV. Provider business mailing address

PO BOX 17471
IRVINE CA
92623-7471
US

V. Phone/Fax

Practice location:
  • Phone: 661-822-4402
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number57449
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: