Healthcare Provider Details

I. General information

NPI: 1568119162
Provider Name (Legal Business Name): BENJAMIN HSEUH-KANG LIANG
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/04/2022
Last Update Date: 03/04/2022
Certification Date: 03/04/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1310 CLUB DR
VALLEJO CA
94592-1187
US

IV. Provider business mailing address

1001 ATHERTON ST
VALLEJO CA
94590-7805
US

V. Phone/Fax

Practice location:
  • Phone: 707-638-5970
  • Fax:
Mailing address:
  • Phone: 559-862-3178
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: