Provider Demographics
NPI:1649307638
Name:SCOTT LIANG MD INC
Entity type:Organization
Organization Name:SCOTT LIANG MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:
Authorized Official - Last Name:LIANG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:626-628-0808
Mailing Address - Street 1:900 S 1ST AVE
Mailing Address - Street 2:STE G
Mailing Address - City:ARCADIA
Mailing Address - State:CA
Mailing Address - Zip Code:91006-3919
Mailing Address - Country:US
Mailing Address - Phone:626-628-0808
Mailing Address - Fax:626-628-0809
Practice Address - Street 1:900 S 1ST AVE
Practice Address - Street 2:STE G
Practice Address - City:ARCADIA
Practice Address - State:CA
Practice Address - Zip Code:91006-3919
Practice Address - Country:US
Practice Address - Phone:626-628-0808
Practice Address - Fax:626-628-0809
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-27
Last Update Date:2012-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA86197207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA9176839Medicaid
CADX163AOtherMEDICARE PTAN
CA222606482OtherBLUE SHIELD
CA222606482OtherBLUE SHIELD
I35748Medicare UPIN