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General NPI Number Information
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NPI Number | 1285983494
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Entity Type | Organization
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Legal Business Name | HENRY K. LIAO, MD INCORPORATED
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Dates
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Enumeration Date | 09/04/2012
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Last Update Date | 09/04/2012
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Provider Practice Location Address
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Address Line | 1532 SAVIERS ROAD
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City | OXNARD
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State | CA
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Zip | 93033-1737
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Country | US
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Telephone | 805-483-8211
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Fax | 805-483-2631
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Provider Business Mailing Address
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Address Line | 1532 SAVIERS ROAD
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City | OXNARD
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State | CA
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Zip | 93033-1737
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Country | US
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Telephone | 805-483-8211
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Fax | 805-483-2631
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Authorized Official
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Title or Position | CEO
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Name | HENRY K. LIAO
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Credential | M.D.
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Telephone | 805-483-8211
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | A100050
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License Number State | CA
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