Provider Demographics
NPI:1093700064
Name:LIANG, PAULYNNE P (MD)
Entity Type:Individual
Prefix:
First Name:PAULYNNE
Middle Name:P
Last Name:LIANG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 LAGUNA RD
Mailing Address - Street 2:6
Mailing Address - City:FULLERTON
Mailing Address - State:CA
Mailing Address - Zip Code:92835-2523
Mailing Address - Country:US
Mailing Address - Phone:714-680-0050
Mailing Address - Fax:
Practice Address - Street 1:955 W IMPERIAL HWY STE 110
Practice Address - Street 2:
Practice Address - City:BREA
Practice Address - State:CA
Practice Address - Zip Code:92821-3814
Practice Address - Country:US
Practice Address - Phone:714-449-6900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-09-15
Last Update Date:2021-11-05
Deactivation Date:2006-03-23
Deactivation Code:
Reactivation Date:2006-04-17
Provider Licenses
StateLicense IDTaxonomies
CAG66406207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAF41077Medicare UPIN