1609188572 NPI number — PI-JU CHRISTINA LIU MD LLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1609188572 NPI number — PI-JU CHRISTINA LIU MD LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PI-JU CHRISTINA LIU MD LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1609188572
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/08/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4348 WAIALAE AVE
Provider Second Line Business Mailing Address:
SUITE 388
Provider Business Mailing Address City Name:
HONOLULU
Provider Business Mailing Address State Name:
HI
Provider Business Mailing Address Postal Code:
96816-5767
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
808-547-4771
Provider Business Mailing Address Fax Number:
808-547-4507

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1301 PUNCHBOWL ST
Provider Second Line Business Practice Location Address:
RADIATION ONCOLOGY DEPARTMENT
Provider Business Practice Location Address City Name:
HONOLULU
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96813-2402
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-547-4771
Provider Business Practice Location Address Fax Number:
808-547-4507
Provider Enumeration Date:
07/08/2010

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
LIU
Authorized Official First Name:
PI-JU
Authorized Official Middle Name:
CHRISTINA
Authorized Official Title or Position:
MEMBER
Authorized Official Telephone Number:
808-547-4771

Provider Taxonomy Codes

  • Taxonomy code: 2085R0001X , with the licence number:  9582 , registered in the state of HI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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