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General NPI Number Information
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NPI Number | 1164652111
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Entity Type | Organization
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Legal Business Name | YEN PO LIU FOOT SPECIALIST INC.
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Dates
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Enumeration Date | 07/23/2009
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Last Update Date | 07/23/2009
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Provider Practice Location Address
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Address Line | 27 W MAIN ST SUITE G
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City | ALHAMBRA
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State | CA
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Zip | 91801-3500
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Country | US
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Telephone | 626-289-4379
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Fax |
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Provider Business Mailing Address
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Address Line | 1710 S LOS ROBLES AVE
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City | SAN MARINO
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State | CA
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Zip | 91108-1623
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Country | US
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Telephone | 626-376-8720
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | YEN-PO LIU
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Credential | DPM
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Telephone | 626-376-8720
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | E4832
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License Number State | CA
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