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General NPI Number Information
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NPI Number | 1104861657
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Entity Type | Organization
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Legal Business Name | DAVID KW LIEU
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Dates
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Enumeration Date | 06/18/2006
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Last Update Date | 03/25/2020
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Provider Practice Location Address
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Address Line | 320 S GARFIELD AVE # 278
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City | ALHAMBRA
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State | CA
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Zip | 91801-3886
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Country | US
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Telephone | 626-281-7800
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Fax | 626-281-7802
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Provider Business Mailing Address
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Address Line | 320 S GARFIELD AVE # 278
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City | ALHAMBRA
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State | CA
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Zip | 91801-3886
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Country | US
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Telephone | 626-281-7800
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Fax | 626-281-7802
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Authorized Official
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Title or Position | PATHOLOGIST
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Name | DAVID KEN WAH LIEU
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Credential | M.D.
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Telephone | 626-281-7800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number | CLF 315077
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License Number State | CA
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