Organization
GRACE LIU MD INC
Active
Other names
Newport Coast Dermatology
Organization subpart
No
Provider details
NPI number
Authorized official
GRACE LIU MD (OWNER)
(714) 571-0228
Entity
Organization
Contact information
Practice address
2700 N. MAIN STREET, STE 115, SANTA ANA, CA 92705-6638
(714) 571-0228
(714) 571-0167
Mailing address
3991 MACARTHUR BLVD, STE 228, NEWPORT BEACH, CA 92660-3009
(949) 863-0988
(949) 863-0088
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
A61446
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A61446
STATE LICENSE
CA
Enumeration date
12/01/2011
Last updated
12/01/2011
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