Provider Demographics
NPI:1841376969
Name:LIU, JONATHAN CHIN HUA (MD)
Entity type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:CHIN HUA
Last Name:LIU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 6430
Mailing Address - Street 2:
Mailing Address - City:VISALIA
Mailing Address - State:CA
Mailing Address - Zip Code:93290-6430
Mailing Address - Country:US
Mailing Address - Phone:559-731-2009
Mailing Address - Fax:866-833-7251
Practice Address - Street 1:2300 W SUNNYSIDE AVE
Practice Address - Street 2:
Practice Address - City:VISALIA
Practice Address - State:CA
Practice Address - Zip Code:93277-7287
Practice Address - Country:US
Practice Address - Phone:559-731-2009
Practice Address - Fax:866-833-7251
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-31
Last Update Date:2022-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA97174208600000X, 2086S0105X, 208600000X
ORMD27909208600000X
NJ25MA08142000208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Yes2086S0105XAllopathic & Osteopathic PhysiciansSurgerySurgery of the HandGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA2282641Medicaid
NMNM001A87OtherBCBS