Provider Demographics
NPI:1386295301
Name:JENNIFER LIEU-CHI HARKINS MD, INC.
Entity type:Organization
Organization Name:JENNIFER LIEU-CHI HARKINS MD, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:LIEU-CHI
Authorized Official - Last Name:HARKINS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-869-7555
Mailing Address - Street 1:2611 BAYSHORE BLVD APT 802
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33629-7362
Mailing Address - Country:US
Mailing Address - Phone:310-869-7555
Mailing Address - Fax:
Practice Address - Street 1:5379 PRIMROSE LAKE CIR
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33647-3521
Practice Address - Country:US
Practice Address - Phone:813-867-0800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-20
Last Update Date:2019-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty