Healthcare Provider Details
I. General information
NPI: 1508924036
Provider Name (Legal Business Name): HANSHENG LIOU PHARM.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 12/05/2006
Last Update Date: 12/03/2021
Certification Date: 12/03/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1425 S MAIN ST
WALNUT CREEK CA
94596-5318
US
IV. Provider business mailing address
2456 BASSWOOD DR
SAN RAMON CA
94582-5656
US
V. Phone/Fax
- Phone: 925-295-4655
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 183500000X |
| Taxonomy | Pharmacist |
| License Number | 55660 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: