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General NPI Number Information
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NPI Number | 1528490554
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Entity Type | Organization
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Legal Business Name | LOS ANGELES ENT SURGICAL ASSOCIATES
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Dates
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Enumeration Date | 08/01/2013
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Last Update Date | 08/01/2013
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Provider Practice Location Address
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Address Line | 1700 E. CESAR CHAVEZ AVE SUITE 2500
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City | LOS ANGELES
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State | CA
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Zip | 90033
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Country | US
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Telephone | 323-268-6731
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Fax |
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Provider Business Mailing Address
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Address Line | 1700 E. CESAR CHAVEZ AVE SUITE 2500
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City | LOS ANGELES
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State | CA
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Zip | 90033
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Country | US
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Telephone | 323-268-6731
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Fax |
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Authorized Official
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Title or Position | CEO/PRESIDENT
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Name | DR. NELSON EDDIE LIOU
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Credential | MD
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Telephone | 832-713-3849
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | A124842
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License Number State | CA
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