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General NPI Number Information
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NPI Number | 1093150559
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Entity Type | Individual
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Provider Name | BRANDY LIU D.O.
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Gender | Female
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Dates
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Enumeration Date | 05/09/2013
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Last Update Date | 04/21/2023
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Provider Practice Location Address
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Address Line | 4193 FLAT ROCK DR STE 200
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City | RIVERSIDE
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State | CA
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Zip | 92505-7113
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Country | US
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Telephone | 626-208-9377
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Fax |
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Provider Business Mailing Address
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Address Line | 5120 HAMNER AVE STE 140 #568
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City | MIRA LOMA
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State | CA
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Zip | 91752-3802
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Country | US
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Telephone | 951-298-9987
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2083A0300X
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Taxonomy Name | Addiction Medicine (Preventive Medicine) Physician
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License Number | 20A14179
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 2083B0002X
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Taxonomy Name | Obesity Medicine (Preventive Medicine) Physician
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License Number | 20A14179
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 2083P0901X
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Taxonomy Name | Public Health & General Preventive Medicine Physician
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License Number | 20A14179
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License Number State | CA
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Taxonomy #4
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Taxonomy Code | 207RA0401X
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Taxonomy Name | Addiction Medicine (Internal Medicine) Physician
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License Number | 20A14179
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License Number State | CA
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