Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | NP20598 | CA |
NPI | 1013207364 |
---|---|
Provider Name | Yi-Tien Liu |
First Address | San Gabriel, CA 91776-3731 |
Second Address | San Gabriel, CA 91776-3731 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/04/2011 |
Last Update Date | 09/09/2014 |