Provider Demographics
NPI:1033349113
Name:LIU, YEN-PO (DPM)
Entity Type:Individual
Prefix:
First Name:YEN-PO
Middle Name:
Last Name:LIU
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:420 N GARFIELD AVE STE 206
Mailing Address - Street 2:
Mailing Address - City:MONTEREY PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91754-1206
Mailing Address - Country:US
Mailing Address - Phone:626-375-7558
Mailing Address - Fax:626-415-6229
Practice Address - Street 1:420 N GARFIELD AVE STE 206
Practice Address - Street 2:
Practice Address - City:MONTEREY PARK
Practice Address - State:CA
Practice Address - Zip Code:91754-1206
Practice Address - Country:US
Practice Address - Phone:626-375-7558
Practice Address - Fax:626-415-6229
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-22
Last Update Date:2024-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE4832213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery