Provider Demographics
NPI:1306374236
Name:LIEWEN, ALISON PAIGE (MD)
Entity Type:Individual
Prefix:
First Name:ALISON
Middle Name:PAIGE
Last Name:LIEWEN
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:PO BOX 277
Mailing Address - Street 2:
Mailing Address - City:BIEBER
Mailing Address - State:CA
Mailing Address - Zip Code:96009-0277
Mailing Address - Country:US
Mailing Address - Phone:530-999-9010
Mailing Address - Fax:
Practice Address - Street 1:50 ALAMO AVE
Practice Address - Street 2:
Practice Address - City:WEED
Practice Address - State:CA
Practice Address - Zip Code:96094-2352
Practice Address - Country:US
Practice Address - Phone:530-999-9050
Practice Address - Fax:530-938-2662
Is Sole Proprietor?:No
Enumeration Date:2017-05-23
Last Update Date:2020-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA170692207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine