1245350206 NPI number — DR. YU PING LIU DDS

Table of content: DR. YU PING LIU DDS (NPI 1245350206)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1245350206 NPI number — DR. YU PING LIU DDS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LIU
Provider First Name:
YU
Provider Middle Name:
PING
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DDS
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
LIU
Provider Other First Name:
DOUGLAS
Provider Other Middle Name:
YU-PING
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
DDS
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1245350206
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3731 N CHARLOTTE AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SAN GABRIEL
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
91776-3951
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
626-628-6338
Provider Business Mailing Address Fax Number:
562-692-1614

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8247 WHITTIER BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PICO RIVERA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90660-2527
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
562-692-1600
Provider Business Practice Location Address Fax Number:
562-692-1614
Provider Enumeration Date:
03/30/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1223G0001X , with the licence number:  39036 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)