Provider Demographics
NPI:1427387869
Name:JONATHAN C. LIU MD INC
Entity Type:Organization
Organization Name:JONATHAN C. LIU MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:C
Authorized Official - Last Name:LIU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:559-731-2036
Mailing Address - Street 1:PO BOX 7507
Mailing Address - Street 2:
Mailing Address - City:VISALIA
Mailing Address - State:CA
Mailing Address - Zip Code:93290-7507
Mailing Address - Country:US
Mailing Address - Phone:559-731-2009
Mailing Address - Fax:559-623-9756
Practice Address - Street 1:518 N COURT ST
Practice Address - Street 2:# B
Practice Address - City:VISALIA
Practice Address - State:CA
Practice Address - Zip Code:93291-4913
Practice Address - Country:US
Practice Address - Phone:559-731-2009
Practice Address - Fax:559-623-9756
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-14
Last Update Date:2010-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA97174207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA97174OtherCALIFOORNIA MEDICAL LICENSE