Provider Demographics
NPI:1477014918
Name:LIANG, JONATHAN LEE (DO)
Entity type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:LEE
Last Name:LIANG
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 4245
Mailing Address - Street 2:
Mailing Address - City:REDONDO BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90277-1759
Mailing Address - Country:US
Mailing Address - Phone:424-703-4292
Mailing Address - Fax:310-905-6417
Practice Address - Street 1:4320 MARICOPA ST
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90503-4314
Practice Address - Country:US
Practice Address - Phone:562-424-1011
Practice Address - Fax:562-424-1027
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-27
Last Update Date:2024-11-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CA20A20938208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation