Provider Demographics
NPI:1942356365
Name:LIU, ZHAO (MD, PHD)
Entity Type:Individual
Prefix:
First Name:ZHAO
Middle Name:
Last Name:LIU
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Gender:F
Credentials:MD, PHD
Other - Prefix:
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Other - Last Name:
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Mailing Address - Street 1:6622 N 91ST AVE
Mailing Address - Street 2:STE 220
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85305-2569
Mailing Address - Country:US
Mailing Address - Phone:602-759-6883
Mailing Address - Fax:602-224-3358
Practice Address - Street 1:2501 N STOCKTON HILL RD STE 102
Practice Address - Street 2:
Practice Address - City:KINGMAN
Practice Address - State:AZ
Practice Address - Zip Code:86401-4140
Practice Address - Country:US
Practice Address - Phone:928-681-2772
Practice Address - Fax:928-681-2833
Is Sole Proprietor?:No
Enumeration Date:2007-01-26
Last Update Date:2021-10-05
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AZ47006207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ47006OtherARIZONA MEDICAL LICENSE
AZ771827Medicaid
AZ771827Medicaid