Provider Demographics
NPI:1083219497
Name:LIU, CHRISTINA WEI LING
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:WEI LING
Last Name:LIU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:472 SAINT FRANCIS BLVD
Mailing Address - Street 2:
Mailing Address - City:DALY CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94015-2135
Mailing Address - Country:US
Mailing Address - Phone:831-295-3689
Mailing Address - Fax:
Practice Address - Street 1:22 SAN PEDRO RD
Practice Address - Street 2:
Practice Address - City:DALY CITY
Practice Address - State:CA
Practice Address - Zip Code:94014-2528
Practice Address - Country:US
Practice Address - Phone:650-756-3412
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-02
Last Update Date:2020-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA83815183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist