Basic Information
| Provider Information | |||||||||
| NPI: | 1013456946 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LIANG | ||||||||
| FirstName: | LINDA | ||||||||
| MiddleName: | JIANHUA | ||||||||
| NamePrefix: | PROF. | ||||||||
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| Credential: | MOT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 934 ESSEX ST | ||||||||
| Address2: | |||||||||
| City: | GLENDORA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 917406712 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6264031983 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1500 SAN PABLO ST | ||||||||
| Address2: | |||||||||
| City: | LOS ANGELES | ||||||||
| State: | CA | ||||||||
| PostalCode: | 900335313 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3234428500 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/12/2017 | ||||||||
| LastUpdateDate: | 02/12/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225X00000X | OT 628 | CA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist |
No ID Information.