Provider Demographics
NPI:1164518072
Name:DENNIS S LIU MD INC
Entity Type:Organization
Organization Name:DENNIS S LIU MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:S
Authorized Official - Last Name:LIU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:626-446-5663
Mailing Address - Street 1:624 W DUARTE RD
Mailing Address - Street 2:SUITE 105
Mailing Address - City:ARCADIA
Mailing Address - State:CA
Mailing Address - Zip Code:91007-9256
Mailing Address - Country:US
Mailing Address - Phone:626-446-4727
Mailing Address - Fax:626-446-5663
Practice Address - Street 1:624 W DUARTE RD
Practice Address - Street 2:SUITE 105
Practice Address - City:ARCADIA
Practice Address - State:CA
Practice Address - Zip Code:91007-9256
Practice Address - Country:US
Practice Address - Phone:626-446-4727
Practice Address - Fax:626-446-5663
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-05
Last Update Date:2015-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA72151207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW17804OtherPTAN