Provider Demographics
NPI:1740972553
Name:LIAN, ANDREW (DO)
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:
Last Name:LIAN
Suffix:
Gender:
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31700 TEMECULA PARKWAY
Mailing Address - Street 2:PARKWAY SUITE #2-GME
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92592
Mailing Address - Country:US
Mailing Address - Phone:951-600-4337
Mailing Address - Fax:
Practice Address - Street 1:31700 TEMECULA PARKWAY
Practice Address - Street 2:PARKWAY SUITE #2-GME
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92592
Practice Address - Country:US
Practice Address - Phone:951-600-4337
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-22
Last Update Date:2025-03-28
Deactivation Date:2025-03-22
Deactivation Code:
Reactivation Date:2025-03-28
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program