Provider Demographics
NPI:1649433541
Name:LIAO, MICHELLE MAYSUE (MD)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:MAYSUE
Last Name:LIAO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3330 LOMITA BLVD
Mailing Address - Street 2:ANESTHESIA OFFICE 2ND FLR
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90505-5002
Mailing Address - Country:US
Mailing Address - Phone:310-517-4759
Mailing Address - Fax:310-517-4658
Practice Address - Street 1:3330 LOMITA BLVD
Practice Address - Street 2:ANESTHESIA OFFICE 2ND FLR
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-5002
Practice Address - Country:US
Practice Address - Phone:310-517-4759
Practice Address - Fax:310-517-4658
Is Sole Proprietor?:No
Enumeration Date:2008-07-10
Last Update Date:2013-09-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NYAT1859644G09207L00000X
CAA119618207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology