Individual
JEFFREY TA LIU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD - LLC
Contact information
Practice address
3040 W CHARLESTON BLVD, LAS VEGAS, NV 89102-1944
(702) 477-0707
(888) 232-5937
Mailing address
3040 W CHARLESTON BLVD, LAS VEGAS, NV 89102-1944
(702) 477-0707
(888) 232-5937
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
7490
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2019887
—
NV
01
—
80-0551016
TAX IDENTIFICATION
NV
01
—
CS7890
NEVADA PHARMACY
NV
Enumeration date
06/14/2006
Last updated
03/07/2023
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