Provider Demographics
NPI:1558547240
Name:CHUN,DU,LIU DENTAL CORPORATION
Entity Type:Organization
Organization Name:CHUN,DU,LIU DENTAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:DR
Authorized Official - First Name:YIWEN
Authorized Official - Middle Name:
Authorized Official - Last Name:LIU
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:323-263-9803
Mailing Address - Street 1:5165 WHITTIER BLVD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90022-3900
Mailing Address - Country:US
Mailing Address - Phone:323-263-9803
Mailing Address - Fax:323-263-8448
Practice Address - Street 1:5165 WHITTIER BLVD
Practice Address - Street 2:SUITE 103
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90022-3900
Practice Address - Country:US
Practice Address - Phone:323-263-9803
Practice Address - Fax:323-263-8448
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-13
Last Update Date:2008-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty