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General NPI Number Information
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NPI Number | 1790725364
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Entity Type | Individual
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Provider Name | JASON Y LIU MD.
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Gender | Male
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Dates
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Enumeration Date | 06/08/2006
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Last Update Date | 09/06/2023
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Provider Practice Location Address
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Address Line | 56 LINDA ISLE
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City | NEWPORT BEACH
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State | CA
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Zip | 92660-7207
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Country | US
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Telephone | 714-507-8101
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Fax | 949-723-0282
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Provider Business Mailing Address
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Address Line | 56 LINDA ISLE
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City | NEWPORT BEACH
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State | CA
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Zip | 92660-7207
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Country | US
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Telephone | 714-507-8101
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Fax | 949-723-0282
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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 | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | G48180
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License Number State | CA
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