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NPI Code Detail

MEDICARE: PEN-LUNG LIAO LMFT

MEDICARE: PEN-LUNG LIAO LMFT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106H00000XMarriage & Family Therapist43668CA

General Provider Information

NPI Number : 1023238573
Entity Type Code : Individual
Provider Name (Legal Business Name) : PEN-LUNG LIAO LMFT
Provider Business Mailing Address
First Line : 1421 BRODERICK ST
Second Line :
City : SAN FRANCISCO
State : CA
Zip : 94115-3304
Country : US
Telephone Number : 415-292-1760
Fax Number : 415-292-1636
Provider Business Practice Location Address
First Line : 1421 BRODERICK STREET
Second Line :
City : SAN FRANCISCO
State : CA
Zip : 94115-3304
Country : US
Telephone Number : 415-292-1760
Fax Number : 415-292-1636
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/26/2007
Last Update Date : 02/19/2008

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Directions to “ PEN-LUNG LIAO LMFT” Practice Location

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