Provider Demographics
NPI:1104019637
Name:LIU, ALICE JIN AI (PHARMD)
Entity Type:Individual
Prefix:
First Name:ALICE
Middle Name:JIN AI
Last Name:LIU
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 1:3733 SAN DIMAS ST
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93301-1407
Mailing Address - Country:US
Mailing Address - Phone:661-631-3010
Mailing Address - Fax:661-631-3011
Practice Address - Street 1:3733 SAN DIMAS ST
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93301-1407
Practice Address - Country:US
Practice Address - Phone:661-631-3010
Practice Address - Fax:661-631-3011
Is Sole Proprietor?:No
Enumeration Date:2007-08-17
Last Update Date:2007-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA50472183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist