Provider Demographics
NPI:1114232246
Name:LIU, CHRISTINE WU (DDS)
Entity Type:Individual
Prefix:DR
First Name:CHRISTINE
Middle Name:WU
Last Name:LIU
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2186 CALIFORNIA ST
Mailing Address - Street 2:APT. #4
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94115-2876
Mailing Address - Country:US
Mailing Address - Phone:408-391-4738
Mailing Address - Fax:
Practice Address - Street 1:2243 VAN NESS AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94109-2504
Practice Address - Country:US
Practice Address - Phone:415-441-2098
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-12
Last Update Date:2010-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA596261223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice