Provider Demographics
NPI:1346623550
Name:LIAO, HUNG-I (MD)
Entity Type:Individual
Prefix:DR
First Name:HUNG-I
Middle Name:
Last Name:LIAO
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:PO BOX 15090
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92803-5090
Mailing Address - Country:US
Mailing Address - Phone:714-577-2124
Mailing Address - Fax:714-577-2125
Practice Address - Street 1:1211 W LA PALMA AVE STE 709
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92801-2814
Practice Address - Country:US
Practice Address - Phone:657-657-7177
Practice Address - Fax:714-772-2321
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-07
Last Update Date:2021-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036.146307207R00000X, 208M00000X
CAA156056207R00000X, 207RC0200X, 208M00000X, 207RP1001X
IL036-146307207R00000X, 207RC0200X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA156056OtherMEDICAL LICENSE