Provider Demographics
NPI:1679041529
Name:LIU, CHEN YUEH
Entity Type:Individual
Prefix:
First Name:CHEN YUEH
Middle Name:
Last Name:LIU
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:328 N GARFIELD AVE STE D
Mailing Address - Street 2:
Mailing Address - City:MONTEREY PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91754-1708
Mailing Address - Country:US
Mailing Address - Phone:949-370-7023
Mailing Address - Fax:
Practice Address - Street 1:328 N GARFIELD AVE STE D
Practice Address - Street 2:
Practice Address - City:MONTEREY PARK
Practice Address - State:CA
Practice Address - Zip Code:91754-1708
Practice Address - Country:US
Practice Address - Phone:626-569-0388
Practice Address - Fax:626-569-9488
Is Sole Proprietor?:No
Enumeration Date:2018-11-08
Last Update Date:2018-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC34312111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAE2348325Medicaid