Provider Demographics
NPI:1801982483
Name:LIANG, TINA (PHARMD)
Entity type:Individual
Prefix:MRS
First Name:TINA
Middle Name:
Last Name:LIANG
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2035 HEARST AVE APT C
Mailing Address - Street 2:
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94709-2225
Mailing Address - Country:US
Mailing Address - Phone:510-486-9969
Mailing Address - Fax:
Practice Address - Street 1:975 SERENO DR
Practice Address - Street 2:INPATIENT PHARMACY
Practice Address - City:VALLEJO
Practice Address - State:CA
Practice Address - Zip Code:94589-2441
Practice Address - Country:US
Practice Address - Phone:707-640-2072
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA54605183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist