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General NPI Number Information
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NPI Number | 1366838633
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Entity Type | Organization
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Legal Business Name | DAVID LIEM OD AND ASSOCIATES, INC
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Dates
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Enumeration Date | 04/13/2015
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Last Update Date | 04/13/2015
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Provider Practice Location Address
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Address Line | 1390 S BEACH BLVD
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City | LA HABRA
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State | CA
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Zip | 90631-6374
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Country | US
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Telephone | 562-691-9541
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Fax |
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Provider Business Mailing Address
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Address Line | 900 RIDGECREST ST
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City | MONTEREY PARK
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State | CA
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Zip | 91754-4623
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Country | US
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Telephone | 626-221-4952
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Fax | 562-697-2108
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Authorized Official
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Title or Position | OWNER
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Name | DR. DAVID J LIEM
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Credential | O.D.
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Telephone | 626-221-4952
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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 | 11793TPL
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License Number State | CA
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