Provider Demographics
NPI:1013145127
Name:LIU, JEFFREY (MD)
Entity type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:
Last Name:LIU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1174 CASTRO ST STE 100
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN VIEW
Mailing Address - State:CA
Mailing Address - Zip Code:94040-2572
Mailing Address - Country:US
Mailing Address - Phone:650-961-2585
Mailing Address - Fax:650-961-6527
Practice Address - Street 1:1174 CASTRO ST STE 100
Practice Address - Street 2:
Practice Address - City:MOUNTAIN VIEW
Practice Address - State:CA
Practice Address - Zip Code:94040-2572
Practice Address - Country:US
Practice Address - Phone:650-961-2585
Practice Address - Fax:650-961-6527
Is Sole Proprietor?:No
Enumeration Date:2009-06-26
Last Update Date:2014-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA 114765207W00000X, 207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology