Basic Information
| Provider Information | |||||||||
| NPI: | 1710366059 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | LIU | ||||||||
| FirstName: | YUCHEN | ||||||||
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| Mailing Information | |||||||||
| Address1: | SUNY AT STONY BROOK 101 NICOLLS RD | ||||||||
| Address2: | DEPARTMENT OF ANESTHESIA | ||||||||
| City: | STONY BROOK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 117948480 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6314442975 | ||||||||
| FaxNumber: | 6314442907 | ||||||||
| Practice Location | |||||||||
| Address1: | 400 N TUSTIN AVE STE 400 | ||||||||
| Address2: | |||||||||
| City: | SANTA ANA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 927053850 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 1461953837 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/19/2015 | ||||||||
| LastUpdateDate: | 06/30/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/30/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 207L00000X | A159502 | CA | Y | Allopathic & Osteopathic Physicians | Anesthesiology |
No ID Information.