Provider Demographics
NPI:1780843953
Name:LIANG, FEN (MD)
Entity Type:Individual
Prefix:
First Name:FEN
Middle Name:
Last Name:LIANG
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 50706
Mailing Address - Street 2:512 E. GUTIERREZ ST. STE. C
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93150-0706
Mailing Address - Country:US
Mailing Address - Phone:805-963-3757
Mailing Address - Fax:805-564-3332
Practice Address - Street 1:314 E CARRILLO ST
Practice Address - Street 2:SUITE 7
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93101-1499
Practice Address - Country:US
Practice Address - Phone:805-886-4370
Practice Address - Fax:805-845-8227
Is Sole Proprietor?:No
Enumeration Date:2008-06-03
Last Update Date:2015-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN47048207R00000X
CAA124673207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1524320Medicaid
TN103I115215Medicare PIN