Provider Demographics
NPI:1417261421
Name:LIU, ALICIA XIAOXI (OD)
Entity Type:Individual
Prefix:
First Name:ALICIA
Middle Name:XIAOXI
Last Name:LIU
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:XIAO
Other - Middle Name:XI
Other - Last Name:LIU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:9031 ACASO DR
Mailing Address - Street 2:
Mailing Address - City:TEMPLE CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91780-3012
Mailing Address - Country:US
Mailing Address - Phone:626-673-3059
Mailing Address - Fax:
Practice Address - Street 1:2707 E VALLEY BLVD
Practice Address - Street 2:SUITE 216
Practice Address - City:WEST COVINA
Practice Address - State:CA
Practice Address - Zip Code:91792-3195
Practice Address - Country:US
Practice Address - Phone:626-810-3398
Practice Address - Fax:626-810-3342
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-02
Last Update Date:2015-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA14027152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist