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General NPI Number Information
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NPI Number | 1144043647
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Entity Type | Organization
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Legal Business Name | DR ANNIE LIU PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 11/04/2024
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Last Update Date | 01/06/2026
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Provider Practice Location Address
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Address Line | 1968 S COAST HWY # 1637
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City | LAGUNA BEACH
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State | CA
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Zip | 92651-3681
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Country | US
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Telephone | 626-466-2541
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Fax |
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Provider Business Mailing Address
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Address Line | 1968 S COAST HWY # 1637
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City | LAGUNA BEACH
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State | CA
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Zip | 92651-3681
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Country | US
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Telephone | 714-202-7128
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Fax | 888-275-4061
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Authorized Official
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Title or Position | DERMATOLOGIST
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Name | ANNIE LIU
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Credential |
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Telephone | 714-202-7128
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number |
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License Number State |
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