Provider Demographics
NPI:1891768479
Name:LIU, JUNE-CHIH (MD)
Entity Type:Individual
Prefix:DR
First Name:JUNE-CHIH
Middle Name:
Last Name:LIU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:JESSE
Other - Middle Name:
Other - Last Name:LIU
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:660 W DUARTE RD STE A
Mailing Address - Street 2:
Mailing Address - City:ARCADIA
Mailing Address - State:CA
Mailing Address - Zip Code:91007-7623
Mailing Address - Country:US
Mailing Address - Phone:626-446-9697
Mailing Address - Fax:626-446-9669
Practice Address - Street 1:660 W DUARTE RD STE A
Practice Address - Street 2:
Practice Address - City:ARCADIA
Practice Address - State:CA
Practice Address - Zip Code:91007-7623
Practice Address - Country:US
Practice Address - Phone:626-446-9697
Practice Address - Fax:626-446-9669
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-13
Last Update Date:2011-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA2774232084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAI45261Medicare UPIN
CAWA77423AMedicare ID - Type UnspecifiedMEDICARE