Provider Demographics
NPI:1689123879
Name:GHIAM, LIAM (MD, MS)
Entity Type:Individual
Prefix:
First Name:LIAM
Middle Name:
Last Name:GHIAM
Suffix:
Gender:M
Credentials:MD, MS
Other - Prefix:DR
Other - First Name:ALIREZA
Other - Middle Name:
Other - Last Name:GHIAM
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD, MS
Mailing Address - Street 1:300 PASTEUR DR
Mailing Address - Street 2:
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94304-2203
Mailing Address - Country:US
Mailing Address - Phone:650-723-4000
Mailing Address - Fax:
Practice Address - Street 1:300 PASTEUR DR
Practice Address - Street 2:
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94304-2203
Practice Address - Country:US
Practice Address - Phone:650-723-4000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-28
Last Update Date:2024-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA1657392085R0001X
PAMD4588522085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology