Provider Demographics
NPI:1790795318
Name:LIU, ALEX CORBIN (OD)
Entity Type:Individual
Prefix:DR
First Name:ALEX
Middle Name:CORBIN
Last Name:LIU
Suffix:
Gender:M
Credentials:OD
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Mailing Address - Street 1:19735 COLIMA RD
Mailing Address - Street 2:#4
Mailing Address - City:ROWLAND HEIGHTS
Mailing Address - State:CA
Mailing Address - Zip Code:91748-3227
Mailing Address - Country:US
Mailing Address - Phone:909-468-4622
Mailing Address - Fax:909-468-4603
Practice Address - Street 1:19735 COLIMA RD
Practice Address - Street 2:#4
Practice Address - City:ROWLAND HEIGHTS
Practice Address - State:CA
Practice Address - Zip Code:91748-3227
Practice Address - Country:US
Practice Address - Phone:909-468-4622
Practice Address - Fax:909-468-4603
Is Sole Proprietor?:No
Enumeration Date:2006-08-08
Last Update Date:2012-12-26
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Provider Licenses
StateLicense IDTaxonomies
CA12329T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAU96416Medicare UPIN