Healthcare Provider Details

I. General information

NPI: 1457558413
Provider Name (Legal Business Name): NI-JUI LIANG M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/02/2007
Last Update Date: 07/26/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3640 LOMITA BLVD STE 306
TORRANCE CA
90505
US

IV. Provider business mailing address

3640 LOMITA BLVD STE 306
TORRANCE CA
90505-3904
US

V. Phone/Fax

Practice location:
  • Phone: 310-784-0644
  • Fax: 310-784-0544
Mailing address:
  • Phone: 310-784-0644
  • Fax: 310-784-0544

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateKS
# 2
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number2014022835
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: