Individual
STEPHEN LIU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1441 EASTLAKE AVE, NOR 8302E, LOS ANGELES, CA 90089-0112
(323) 865-3105
Mailing address
PO BOX 31309, LOS ANGELES, CA 90031-0309
(323) 865-3105
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
A102491
CA
207R00000X
Internal Medicine Physician
MT186453
PA
207RX0202X
Medical Oncology Physician
Primary
A102491
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1902846306
GROUP NPI
CA
01
—
GR0100430
GROUP MEDICAL
CA
01
—
W18762
GROUP MEDICARE
CA
Enumeration date
12/21/2006
Last updated
04/23/2012
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