Healthcare Provider Details

I. General information

NPI: 1346510575
Provider Name (Legal Business Name): LUCY H LIU
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: HSINLU LIU

II. Dates (important events)

Enumeration Date: 01/04/2012
Last Update Date: 02/01/2023
Certification Date: 02/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

275 W MACARTHUR BLVD
OAKLAND CA
94611-5641
US

IV. Provider business mailing address

733 N BROADWAY SUITE 147
BALTIMORE MD
21205-1832
US

V. Phone/Fax

Practice location:
  • Phone: 510-752-1275
  • Fax:
Mailing address:
  • Phone: 410-955-3080
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License NumberA134583
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: