Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | A157220 | CA |
Y | 207XX0005X | Sports Medicine Orthopaedic Surgeon | A157220 | CA |
NPI | 1154689248 |
---|---|
Provider Name | Dr. Joseph Liu |
First Address | Los Angeles, CA 90031-0309 |
Second Address | Los Angeles, CA 90033-5322 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/04/2012 |
Last Update Date | 01/09/2021 |