Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223G0001X | General Practice | 19111 | CA |
Y | 213EG0000X | General Practice | 19111 | CA |
NPI | 1003806001 |
---|---|
Provider Name | Dr. Barry Randall Liu |
First Address | Berkeley, CA 94707-2308 |
Second Address | Berkeley, CA 94707-2308 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/10/2005 |
Last Update Date | 08/07/2007 |