Liu, Connie C

Liu, Connie C is an individual health care provider with primary practice located at 2248 D St , La Verne CA 91750-5403. She recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as her primary health care specialty. Liu, Connie C can be contacted via phone (909) 593-3519.

Contact Information

Primary practice address
2248 D St La Verne CA 91750-5403
Fax: (909) 593-3521
Website:

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 13043T California

Profile Details

NPI number 1396859476
LBN Legal business name Liu, Connie C
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 18th, 2006
Last updated Dec 1st, 2021 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1396859476 NPPES
Other 1396859476 MEDI-CAL

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