Provider Demographics
NPI:1457905143
Name:LIU, EMILY (OD)
Entity Type:Individual
Prefix:DR
First Name:EMILY
Middle Name:
Last Name:LIU
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3233 GRAND AVE STE M
Mailing Address - Street 2:
Mailing Address - City:CHINO HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91709-1489
Mailing Address - Country:US
Mailing Address - Phone:909-591-2034
Mailing Address - Fax:909-591-2176
Practice Address - Street 1:3233 GRAND AVE STE M
Practice Address - Street 2:
Practice Address - City:CHINO HILLS
Practice Address - State:CA
Practice Address - Zip Code:91709-1489
Practice Address - Country:US
Practice Address - Phone:909-591-2034
Practice Address - Fax:909-591-2176
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-31
Last Update Date:2023-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA34294TLG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist