Basic Information
| Provider Information | |||||||||
| NPI: | 1285806091 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LIAUW | ||||||||
| FirstName: | JASON | ||||||||
| MiddleName: | A | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 2426 | ||||||||
| Address2: | |||||||||
| City: | LAGUNA HILLS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 926542426 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9495885800 | ||||||||
| FaxNumber: | 9493803345 | ||||||||
| Practice Location | |||||||||
| Address1: | 23961 CALLE DE LA MAGDALENA STE 405 | ||||||||
| Address2: | |||||||||
| City: | LAGUNA HILLS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 926533683 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9495885800 | ||||||||
| FaxNumber: | 9493803345 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/01/2008 | ||||||||
| LastUpdateDate: | 09/12/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207T00000X | A137960 | CA | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Neurological Surgery |
No ID Information.