Provider Demographics
NPI:1033542154
Name:LIAO, PAMELA (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:PAMELA
Middle Name:
Last Name:LIAO
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27929 RIDGEBROOK CT
Mailing Address - Street 2:
Mailing Address - City:RANCHO PALOS VERDES
Mailing Address - State:CA
Mailing Address - Zip Code:90275-3302
Mailing Address - Country:US
Mailing Address - Phone:626-340-3181
Mailing Address - Fax:
Practice Address - Street 1:27929 RIDGEBROOK CT
Practice Address - Street 2:
Practice Address - City:RANCHO PALOS VERDES
Practice Address - State:CA
Practice Address - Zip Code:90275-3302
Practice Address - Country:US
Practice Address - Phone:626-340-3181
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-12
Last Update Date:2013-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA68228183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist