Provider Demographics
NPI:1538213525
Name:LIU, YOW WEN (RPH)
Entity type:Individual
Prefix:
First Name:YOW
Middle Name:WEN
Last Name:LIU
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1844 NORIEGA ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94122-4324
Mailing Address - Country:US
Mailing Address - Phone:415-661-0790
Mailing Address - Fax:415-661-0639
Practice Address - Street 1:1844 NORIEGA ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94122-4324
Practice Address - Country:US
Practice Address - Phone:415-661-0790
Practice Address - Fax:415-661-0639
Is Sole Proprietor?:No
Enumeration Date:2007-01-23
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH43206183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA4132420001Medicare NSC
CA9037025Medicare UPIN