MEDICARE: TERRENCE EDWARD LIU M.D.

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	208000000X	Pediatrics Physician	A00067388	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1285619825
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TERRENCE EDWARD LIU M.D.

Provider Business Mailing Address
First Line	:	15944 LOS SERRANOS COUNTRY CLUB DR
Second Line	:	SUITE 220
City	:	CHINO HILLS
State	:	CA
Zip	:	91709-3993
Country	:	US
Telephone Number	:	909-393-6202
Fax Number	:	909-363-6204

Provider Business Practice Location Address
First Line	:	15944 LOS SERRANOS COUNTRY CLUB DR
Second Line	:	SUITE 220
City	:	CHINO HILLS
State	:	CA
Zip	:	91709-3993
Country	:	US
Telephone Number	:	909-393-6202
Fax Number	:	909-393-6204

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/07/2005
Last Update Date	:	07/02/2014

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Directions to “ TERRENCE EDWARD LIU M.D.” Practice Location

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