Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0400X | Neurologist | A139170 | CA |
N | 2084N0600X | Clinical Neurophysiologist | A139170 | CA |
NPI | 1003234550 |
---|---|
Provider Name | Pei Liu |
First Address | Riverside, CA 92505-3370 |
Second Address | Redlands, CA 92373 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/04/2014 |
Last Update Date | 23/07/2019 |