Provider Demographics
NPI:1942234018
Name:WU, LIZA CG (MD)
Entity Type:Individual
Prefix:
First Name:LIZA
Middle Name:CG
Last Name:WU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:2930 NW 26TH AVE
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33434-3664
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5295 TOWN CENTER RD
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33486-1080
Practice Address - Country:US
Practice Address - Phone:561-717-3181
Practice Address - Fax:561-717-3191
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2023-01-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD429047208200000X
FLME157381208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery