MEDICARE: STEVEN K. LIU, DDS, INC.

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	1223G0001X	General Practice Dentistry

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	D30614-01	OTHER	CA	MEDI-CAL

General Provider Information

NPI Number	:	1982885729
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STEVEN K. LIU, DDS, INC.

Provider Business Mailing Address
First Line	:	455 N. MEDNIK AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90022-1324
Country	:	US
Telephone Number	:	323-267-1343
Fax Number	:	323-267-1950

Provider Business Practice Location Address
First Line	:	455 N. MEDNIK AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90022-1324
Country	:	US
Telephone Number	:	323-267-1343
Fax Number	:	323-267-1950

Authorized Official
Title or Position	:	CEO
Name	:	DR. STEVEN K LIU
Credential	:	DDS
Telephone Number	:	626-622-1343

Provider Enumeration Date	:	11/20/2007
Last Update Date	:	10/08/2019

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