Individual
CASSIDY CARINA LIU KOO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
11980 MOUNT VERNON AVE, GRAND TERRACE, CA 92313-5172
(909) 864-1097
Mailing address
11980 MOUNT VERNON AVE, GRAND TERRACE, CA 92313-5172
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
190520
CA
Other
Enumeration date
03/29/2022
Last updated
07/15/2025
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