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General NPI Number Information
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NPI Number | 1134692031
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Entity Type | Organization
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Legal Business Name | MEGAN LIEU OD
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Dates
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Enumeration Date | 01/03/2019
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Last Update Date | 01/03/2019
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Provider Practice Location Address
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Address Line | 18052 CULVER DR
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City | IRVINE
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State | CA
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Zip | 92612-2730
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Country | US
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Telephone | 949-502-0123
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Fax |
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Provider Business Mailing Address
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Address Line | 16242 WATSON CIR
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City | WESTMINSTER
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State | CA
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Zip | 92683-7735
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Country | US
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Telephone | 714-697-3220
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Fax |
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Authorized Official
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Title or Position | OWNER/OPTOMETRIST
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Name | MEGAN M LIEU
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Credential |
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Telephone | 714-697-3220
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number |
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License Number State |
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