Provider Demographics
NPI:1649217357
Name:LIEN, NHA T (MD)
Entity Type:Individual
Prefix:
First Name:NHA
Middle Name:T
Last Name:LIEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2568
Mailing Address - Street 2:
Mailing Address - City:LITCHFIELD PARK
Mailing Address - State:AZ
Mailing Address - Zip Code:85340-2568
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:28248 N TATUM BLVD
Practice Address - Street 2:BLDG B-1 #605
Practice Address - City:CAVE CREEK
Practice Address - State:AZ
Practice Address - Zip Code:85331-6343
Practice Address - Country:US
Practice Address - Phone:602-996-5595
Practice Address - Fax:602-996-5610
Is Sole Proprietor?:No
Enumeration Date:2006-06-01
Last Update Date:2014-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA78612207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A786120Medicaid
CA00A786120Medicaid