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General NPI Number Information
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NPI Number | 1689174351
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Entity Type | Individual
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Provider Name | CHUCHU LIU DO
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Gender | Female
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Dates
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Enumeration Date | 02/19/2018
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Last Update Date | 12/10/2025
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Provider Practice Location Address
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Address Line | 34800 BOB WILSON DR
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City | SAN DIEGO
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State | CA
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Zip | 92134-1098
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Country | US
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Telephone | 646-525-0595
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Fax |
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Provider Business Mailing Address
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Address Line | 6515 YELLOWSTONE BLVD APT 3C
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City | FOREST HILLS
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State | NY
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Zip | 11375-1745
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Country | US
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Telephone |
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 0102205787
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License Number State | VA
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