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General NPI Number Information
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NPI Number | 1710967914
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Entity Type | Individual
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Provider Name | MARK YEEJEN LIU DO
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Gender | Male
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Dates
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Enumeration Date | 01/23/2006
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Last Update Date | 04/16/2025
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Provider Practice Location Address
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Address Line | 6644 LONETREE BLVD STE 300
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City | ROCKLIN
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State | CA
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Zip | 95765-4432
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Country | US
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Telephone | 916-721-2977
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Fax | 916-659-9629
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Provider Business Mailing Address
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Address Line | 7978 POCKET RD APT 154
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City | SACRAMENTO
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State | CA
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Zip | 95831-5726
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Country | US
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Telephone | 509-730-4720
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | DOS-1207
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License Number State | HI
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | OP1714
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License Number State | WA
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 20A22527
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License Number State | CA
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