MEDICARE: DR ANNIE LIU CORP

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
1	207N00000X	Dermatology Physician

General Provider Information

NPI Number	:	1144043647
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DR ANNIE LIU CORP

Provider Business Mailing Address
First Line	:	1968 S COAST HWY # 1637
Second Line	:
City	:	LAGUNA BEACH
State	:	CA
Zip	:	92651-3681
Country	:	US
Telephone Number	:	714-202-7128
Fax Number	:	888-275-4061

Provider Business Practice Location Address
First Line	:	1968 S COAST HWY # 1637
Second Line	:
City	:	LAGUNA BEACH
State	:	CA
Zip	:	92651-3681
Country	:	US
Telephone Number	:	626-466-2541
Fax Number	:

Authorized Official
Title or Position	:	DERMATOLOGIST
Name	:	ANNIE LIU
Credential	:
Telephone Number	:	714-202-7128

Provider Enumeration Date	:	11/04/2024
Last Update Date	:	03/06/2026

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Directions to “DR ANNIE LIU CORP ” Practice Location

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