Provider Demographics
NPI:1285619825
Name:LIU, TERRENCE EDWARD (MD)
Entity type:Individual
Prefix:
First Name:TERRENCE
Middle Name:EDWARD
Last Name:LIU
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:15944 LOS SERRANOS COUNTRY CLUB DR
Mailing Address - Street 2:SUITE 220
Mailing Address - City:CHINO HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91709-3993
Mailing Address - Country:US
Mailing Address - Phone:909-393-6202
Mailing Address - Fax:909-363-6204
Practice Address - Street 1:15944 LOS SERRANOS COUNTRY CLUB DR
Practice Address - Street 2:SUITE 220
Practice Address - City:CHINO HILLS
Practice Address - State:CA
Practice Address - Zip Code:91709-3993
Practice Address - Country:US
Practice Address - Phone:909-393-6202
Practice Address - Fax:909-393-6204
Is Sole Proprietor?:No
Enumeration Date:2005-12-07
Last Update Date:2014-07-02
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Provider Licenses
StateLicense IDTaxonomies
CAA00067388208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00673880Medicaid
CA1285619825Medicaid