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General NPI Number Information
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NPI Number | 1659917045
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Entity Type | Individual
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Provider Name | STEPHEN JARYUAN LIU RPH
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Gender | Male
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Dates
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Enumeration Date | 11/21/2019
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Last Update Date | 11/21/2019
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Provider Practice Location Address
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Address Line | 770 S HIGHWAY 160
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City | PAHRUMP
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State | NV
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Zip | 89048
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Country | US
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Telephone | 775-751-8399
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Fax |
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Provider Business Mailing Address
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Address Line | 472 SAINT FRANCIS BLVD
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City | DALY CITY
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State | CA
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Zip | 94015-2135
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Country | US
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Telephone | 530-219-1283
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 20365
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License Number State | NV
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