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General NPI Number Information
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NPI Number | 1114216249
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Entity Type | Individual
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Provider Name | JEWEL LIAO MD
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Gender | Female
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Dates
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Enumeration Date | 03/29/2011
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Last Update Date | 10/28/2021
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Provider Practice Location Address
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Address Line | 3114 TELEGRAPH RD STE A
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City | VENTURA
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State | CA
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Zip | 93003-3219
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Country | US
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Telephone | 805-648-6891
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Fax | 805-648-6386
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Provider Business Mailing Address
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Address Line | 3114 TELEGRAPH RD STE A
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City | VENTURA
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State | CA
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Zip | 93003-3219
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Country | US
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Telephone | 805-648-6891
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Fax | 805-648-6386
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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 | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 268709
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | C171723
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License Number State | CA
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