Provider Demographics
NPI:1982668026
Name:LIU, HOWARD LEE (MD)
Entity Type:Individual
Prefix:DR
First Name:HOWARD
Middle Name:LEE
Last Name:LIU
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Gender:M
Credentials:MD
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Mailing Address - Street 1:118 S CLARK DR
Mailing Address - Street 2:UNIT 204
Mailing Address - City:WEST HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90048-3274
Mailing Address - Country:US
Mailing Address - Phone:310-888-2844
Mailing Address - Fax:310-888-7793
Practice Address - Street 1:200 N ROBERTSON BLVD
Practice Address - Street 2:SUITE 202
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90211-1769
Practice Address - Country:US
Practice Address - Phone:310-385-3300
Practice Address - Fax:310-385-3366
Is Sole Proprietor?:No
Enumeration Date:2006-04-14
Last Update Date:2009-04-24
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Provider Licenses
StateLicense IDTaxonomies
CAA761770207N00000X, 207ND0101X, 207ND0900X, 207NI0002X, 207NS0135X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic Surgery
No207ND0900XAllopathic & Osteopathic PhysiciansDermatologyDermatopathology
No207NI0002XAllopathic & Osteopathic PhysiciansDermatologyClinical & Laboratory Dermatological Immunology
No207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural Dermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAI13498Medicare UPIN