Basic Information
| Provider Information | |||||||||
| NPI: | 1215321575 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | YU CHUAN LIU MD INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 1885 | ||||||||
| Address2: | |||||||||
| City: | CARMEL | ||||||||
| State: | CA | ||||||||
| PostalCode: | 939211885 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6503073991 | ||||||||
| FaxNumber: | 8313721666 | ||||||||
| Practice Location | |||||||||
| Address1: | 1441 CONSTITUTION BLVD BLDG 500 | ||||||||
| Address2: | |||||||||
| City: | SALINAS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 939063100 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8317961630 | ||||||||
| FaxNumber: | 8313721666 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/25/2015 | ||||||||
| LastUpdateDate: | 07/10/2015 | ||||||||
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| AuthorizedOfficialLastName: | LIU | ||||||||
| AuthorizedOfficialFirstName: | YU CHUAN | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 6503073991 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RC0001X | A64763 | CA | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Clinical Cardiac Electrophysiology |
ID Information
| ID | Type | State | Issuer | Description | 00A647630 | 05 | CA | MEDICAID |