Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 1223G0001X | General Practice | 52752 | CA |
N | 213EG0000X | General Practice | 52752 | CA |
N | 1223P0300X | Periodontist | 52752 | CA |
NPI | 1013961853 |
---|---|
Provider Name | Karen Yong Liu |
First Address | San Diego, CA 92127-5830 |
Second Address | Chula Vista, CA 91910 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/05/2006 |
Last Update Date | 08/07/2007 |