Provider Demographics
NPI:1235681297
Name:LIU, THOMAS TING-WEI
Entity type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:TING-WEI
Last Name:LIU
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1540 ALCAZAR ST
Mailing Address - Street 2:CHP-133
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90089-0080
Mailing Address - Country:US
Mailing Address - Phone:323-442-3550
Mailing Address - Fax:
Practice Address - Street 1:7120 HAYVENHURST AVE STE 215
Practice Address - Street 2:
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91406-3813
Practice Address - Country:US
Practice Address - Phone:818-785-9515
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-25
Last Update Date:2019-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program