MEDICARE: DR. MEGAN M LIEU O.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	152W00000X	Optometrist	12917	CA

General Provider Information

NPI Number	:	1851443998
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MEGAN M LIEU O.D.

Provider Business Mailing Address
First Line	:	10031 MALLARD DR
Second Line	:
City	:	GARDEN GROVE
State	:	CA
Zip	:	92843-3137
Country	:	US
Telephone Number	:	714-697-3220
Fax Number	:

Provider Business Practice Location Address
First Line	:	2831 PARK AVE
Second Line	:
City	:	TUSTIN
State	:	CA
Zip	:	92782-2711
Country	:	US
Telephone Number	:	714-258-7525
Fax Number	:

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

Provider Enumeration Date	:	01/17/2007
Last Update Date	:	09/01/2022

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