Provider Demographics
NPI:1134131196
Name:LIANG, LEONARD WEI-CHANG (MD)
Entity Type:Individual
Prefix:
First Name:LEONARD
Middle Name:WEI-CHANG
Last Name:LIANG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:46 VIA CAPRI
Mailing Address - Street 2:
Mailing Address - City:RANCHO PALOS VERDES
Mailing Address - State:CA
Mailing Address - Zip Code:90275-5372
Mailing Address - Country:US
Mailing Address - Phone:213-484-1140
Mailing Address - Fax:213-484-0185
Practice Address - Street 1:201 S ALVARADO ST
Practice Address - Street 2:SUITE 215
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90057-2320
Practice Address - Country:US
Practice Address - Phone:213-484-1140
Practice Address - Fax:213-484-0158
Is Sole Proprietor?:No
Enumeration Date:2006-08-11
Last Update Date:2008-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA66024174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAH66760Medicare UPIN