Provider Demographics
NPI:1427211721
Name:DR. JANE H. LIANG O.D. INC
Entity Type:Organization
Organization Name:DR. JANE H. LIANG O.D. INC
Other - Org Name:JANE H. LIANG
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JANE
Authorized Official - Middle Name:
Authorized Official - Last Name:LIANG
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:626-330-4115
Mailing Address - Street 1:2115 S HACIENDA BLVD
Mailing Address - Street 2:
Mailing Address - City:HACIENDA HEIGHTS
Mailing Address - State:CA
Mailing Address - Zip Code:91745-4243
Mailing Address - Country:US
Mailing Address - Phone:626-330-4115
Mailing Address - Fax:626-330-4116
Practice Address - Street 1:2115 S HACIENDA BLVD
Practice Address - Street 2:
Practice Address - City:HACIENDA HEIGHTS
Practice Address - State:CA
Practice Address - Zip Code:91745-4243
Practice Address - Country:US
Practice Address - Phone:626-330-4115
Practice Address - Fax:626-330-4116
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-07
Last Update Date:2023-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACA 11266T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CASD0112661Medicaid
CAW17858Medicare PIN