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General NPI Number Information
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NPI Number | 1174694210
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Entity Type | Individual
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Provider Name | CHING CHENG LIU D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 11/12/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 19103 BLOOMFIELD AVE
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City | CERRITOS
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State | CA
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Zip | 90703-7104
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Country | US
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Telephone | 562-402-1918
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Fax | 562-924-7669
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Provider Business Mailing Address
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Address Line | 3671 N MALL ST
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City | IRVINE
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State | CA
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Zip | 92606-1706
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Country | US
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Telephone | 949-231-9547
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Fax |
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 48319
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License Number State | CA
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