Healthcare Provider Details

I. General information

NPI: 1215252846
Provider Name (Legal Business Name): ALFRED J. LIU MD, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/07/2010
Last Update Date: 04/07/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1329 LUSITANA ST SUITE 407
HONOLULU HI
96813-2429
US

IV. Provider business mailing address

1329 LUSITANA ST SUITE 407
HONOLULU HI
96813-2429
US

V. Phone/Fax

Practice location:
  • Phone: 808-533-3368
  • Fax: 808-536-4249
Mailing address:
  • Phone: 808-533-3368
  • Fax: 808-536-4249

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License NumberMD4799
License Number StateHI

VIII. Authorized Official

Name: MR. ALFRED J LIU
Title or Position: OWNER
Credential: MD
Phone: 808-533-3368