Provider Demographics
NPI:1609106459
Name:LIU, TONY TONGYU (DO, MPH)
Entity Type:Individual
Prefix:
First Name:TONY
Middle Name:TONGYU
Last Name:LIU
Suffix:
Gender:M
Credentials:DO, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1535 W MERCED AVE STE 208
Mailing Address - Street 2:
Mailing Address - City:WEST COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91790-3404
Mailing Address - Country:US
Mailing Address - Phone:626-655-8286
Mailing Address - Fax:410-934-1493
Practice Address - Street 1:1535 W MERCED AVE STE 208
Practice Address - Street 2:
Practice Address - City:WEST COVINA
Practice Address - State:CA
Practice Address - Zip Code:91790-3404
Practice Address - Country:US
Practice Address - Phone:626-655-8286
Practice Address - Fax:410-934-1493
Is Sole Proprietor?:No
Enumeration Date:2009-12-29
Last Update Date:2022-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A12147208100000X, 2081P2900X, 208VP0014X, 208VP0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
No2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
No208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine