Individual
JASEN LIU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
10833 LE CONTE AVE, LOS ANGELES, CA 90095-7419
(310) 825-0867
Mailing address
5767 W CENTURY BLVD STE 400, LOS ANGELES, CA 90045-5631
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
A135227
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/06/2013
Last updated
10/15/2024
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