Provider Demographics
NPI:1396010856
Name:LIANG, BERTRAND (MD)
Entity Type:Individual
Prefix:DR
First Name:BERTRAND
Middle Name:
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 1:13638 FIFE CT
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80921-1308
Mailing Address - Country:US
Mailing Address - Phone:858-603-5963
Mailing Address - Fax:
Practice Address - Street 1:13638 FIFE CT
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80921-1308
Practice Address - Country:US
Practice Address - Phone:858-603-5963
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-16
Last Update Date:2023-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ697772084N0400X
COCDRH.00343852084N0400X
KS04-485852084N0400X
CAG862882084N0400X
GA967352084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology