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General NPI Number Information
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NPI Number | 1346801933
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Entity Type | Individual
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Provider Name | TAMMY LIU NA O.D.
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Gender | Female
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Dates
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Enumeration Date | 06/24/2019
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Last Update Date | 06/24/2019
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Provider Practice Location Address
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Address Line | 15333 CULVER DR STE 690
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City | IRVINE
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State | CA
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Zip | 92604-7143
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Country | US
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Telephone | 949-552-4271
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Fax |
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Provider Business Mailing Address
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Address Line | 339 MEMORY LN
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City | SANTA ANA
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State | CA
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Zip | 92705-6021
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Country | US
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Telephone | 909-634-0867
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 34240TLG
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License Number State | CA
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