Individual
DAVID M K I LIU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD, PHD
Contact information
Practice address
2201 SOUTH AVE, SOUTH LAKE TAHOE, CA 96150-7025
(530) 543-5623
(530) 541-5738
Mailing address
1111 EMERALD BAY RD, SOUTH LAKE TAHOE, CA 96150-6207
(530) 543-5659
(530) 541-8723
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
13414
HI
207R00000X
Internal Medicine Physician
C56003
CA
208000000X
Pediatrics Physician
13414
HI
208000000X
Pediatrics Physician
Primary
C56003
CA
Other
Enumeration date
10/12/2006
Last updated
09/03/2015
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