Provider Demographics
NPI:1669697892
Name:LIU, HENRY C (MD)
Entity type:Individual
Prefix:DR
First Name:HENRY
Middle Name:C
Last Name:LIU
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:325 DISTEL CIR
Mailing Address - Street 2:
Mailing Address - City:LOS ALTOS
Mailing Address - State:CA
Mailing Address - Zip Code:94022-1408
Mailing Address - Country:US
Mailing Address - Phone:925-779-7274
Mailing Address - Fax:925-779-3026
Practice Address - Street 1:3901 LONE TREE WAY
Practice Address - Street 2:
Practice Address - City:ANTIOCH
Practice Address - State:CA
Practice Address - Zip Code:94509
Practice Address - Country:US
Practice Address - Phone:925-779-7274
Practice Address - Fax:925-779-3026
Is Sole Proprietor?:No
Enumeration Date:2007-04-14
Last Update Date:2019-07-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA871521207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA91763OtherSTATE MEDICAL LICENSE