Provider Demographics
NPI:1326178773
Name:GENE C. LIU, M.D., INC
Entity Type:Organization
Organization Name:GENE C. LIU, M.D., INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OTOLARYNGOLOGY
Authorized Official - Prefix:DR
Authorized Official - First Name:GENE
Authorized Official - Middle Name:C
Authorized Official - Last Name:LIU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-652-5700
Mailing Address - Street 1:8631 W 3RD ST
Mailing Address - Street 2:SUITE 225E
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90048-5901
Mailing Address - Country:US
Mailing Address - Phone:310-652-5700
Mailing Address - Fax:310-652-0405
Practice Address - Street 1:8631 W 3RD ST
Practice Address - Street 2:SUITE 225E
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90048-5901
Practice Address - Country:US
Practice Address - Phone:310-652-5700
Practice Address - Fax:310-652-0405
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-06
Last Update Date:2007-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA90107174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1972517167Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER