Provider Demographics
NPI:1932512597
Name:LIU, SHIRLEY (RPH)
Entity Type:Individual
Prefix:MS
First Name:SHIRLEY
Middle Name:
Last Name:LIU
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3601 E FOOTHILL BLVD
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91107-3121
Mailing Address - Country:US
Mailing Address - Phone:626-351-6572
Mailing Address - Fax:626-351-0839
Practice Address - Street 1:3601 E FOOTHILL BLVD
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91107-3121
Practice Address - Country:US
Practice Address - Phone:626-351-6572
Practice Address - Fax:626-351-0839
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-11
Last Update Date:2014-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH 32354183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist