Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RN0300X | Nephrologist | G55369 | CA |
NPI | 1013029313 |
---|---|
Provider Name | Chaplin Li-Cho Liu |
First Address | San Leandro, CA 94578 |
Second Address | San Leadnro, CA 94578 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2006 |
Last Update Date | 17/12/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00G553691 | (05) | CA |
E90705 | (02) |