Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0103X | Foot & Ankle Surgery | 000758 | MO |
NPI | 1013911395 |
---|---|
Provider Name | Dr. Sophie I Liu |
First Address | San Diego, CA 92122-5660 |
Second Address | San Diego, CA 92111-1428 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/06/2005 |
Last Update Date | 07/10/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U66550 | (02) | MO |