Individual
DR. CARSON DAVID LIU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.,F.A.C.S.
Contact information
Practice address
1301 20TH ST, SUITE 440, SANTA MONICA, CA 90404
(310) 208-0474
(310) 208-0374
Mailing address
1301 20TH ST., SUITE 440, SANTA MONICA, CA 90404
(310) 208-0474
(310) 208-0374
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
G75372
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00G753720
MEDICAL PPIN #
CA
Enumeration date
07/26/2006
Last updated
04/11/2011
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