Basic Information
| Provider Information | |||||||||
| NPI: | 1457577876 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | DRS. LIU & LONGACRE, INC. | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | FOOTHILL OPTOMETRIC GROUP | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6155 STONERIDGE DR | ||||||||
| Address2: | SUITE 100 | ||||||||
| City: | PLEASANTON | ||||||||
| State: | CA | ||||||||
| PostalCode: | 945883204 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9254632150 | ||||||||
| FaxNumber: | 9254631186 | ||||||||
| Practice Location | |||||||||
| Address1: | 6155 STONERIDGE DRIVE | ||||||||
| Address2: | SUITE100 | ||||||||
| City: | PLEASANTON | ||||||||
| State: | CA | ||||||||
| PostalCode: | 945883462 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9254632150 | ||||||||
| FaxNumber: | 9254631186 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/17/2007 | ||||||||
| LastUpdateDate: | 05/15/2019 | ||||||||
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| ProviderGenderCode: | |||||||||
| AuthorizedOfficialLastName: | LIU | ||||||||
| AuthorizedOfficialFirstName: | DRS LIU AND LONGACRE | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | OWENS | ||||||||
| AuthorizedOfficialTelephone: | 9254632150 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | O.D. | ||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 152W00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Eye and Vision Services Providers | Optometrist |
No ID Information.