Provider Demographics
NPI:1912078411
Name:HALL, BERNARD LIANG (MD)
Entity Type:Individual
Prefix:DR
First Name:BERNARD
Middle Name:LIANG
Last Name:HALL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:BERNARD
Other - Middle Name:LIANG
Other - Last Name:HO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2852 SAWTELLE BLVD
Mailing Address - Street 2:APT 18
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90064-3752
Mailing Address - Country:US
Mailing Address - Phone:714-387-4069
Mailing Address - Fax:
Practice Address - Street 1:441 N LAKEVIEW AVE
Practice Address - Street 2:KAISER PERMANENTE LAKEVIEW
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92807-3028
Practice Address - Country:US
Practice Address - Phone:714-279-2800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-13
Last Update Date:2021-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA78128207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine