Healthcare Provider Details

I. General information

NPI: 1043444615
Provider Name (Legal Business Name): KIRSTEN LIU M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/11/2009
Last Update Date: 12/19/2022
Certification Date: 12/19/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3330 LOMITA BLVD
TORRANCE CA
90505-5002
US

IV. Provider business mailing address

3330 LOMITA BLVD
TORRANCE CA
90505-5002
US

V. Phone/Fax

Practice location:
  • Phone: 310-784-4997
  • Fax:
Mailing address:
  • Phone: 323-538-0538
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberTL-3177
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number51219
License Number StateCO
# 3
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberA123757
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: