Healthcare Provider Details

I. General information

NPI: 1992952741
Provider Name (Legal Business Name): WENDY LIU M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/23/2008
Last Update Date: 12/06/2021
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5601 DE SOTO AVE DEPARTMENT OF GENERAL SURGERY
WOODLAND HILLS CA
91367-6701
US

IV. Provider business mailing address

5601 DE SOTO AVE DEPARTMENT OF GENERAL SURGERY
WOODLAND HILLS CA
91367-6701
US

V. Phone/Fax

Practice location:
  • Phone: 818-719-3750
  • Fax: 818-719-2212
Mailing address:
  • Phone: 818-719-3750
  • Fax: 818-719-2212

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberA109893
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code208C00000X
TaxonomyColon & Rectal Surgery Physician
License NumberA109893
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: