Individual
DR. MARY LIEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
10800 MAGNOLIA AVE, RIVERSIDE, CA 92505-3043
(951) 353-2000
(813) 974-2132
Mailing address
10800 MAGNOLIA AVE, RIVERSIDE, CA 92505-3043
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
A55676
CA
207N00000X
Dermatology Physician
ME71253
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
250460000
—
FL
01
—
31538
BLUE CROSS BLUE SHIELD
FL
Enumeration date
12/06/2006
Last updated
12/02/2021
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