Healthcare Provider Details

I. General information

NPI: 1497135156
Provider Name (Legal Business Name): XIONGFEI LIU M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/08/2015
Last Update Date: 07/21/2022
Certification Date: 07/21/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1515 RESPONSE RD
SACRAMENTO CA
95815-4805
US

IV. Provider business mailing address

1515 RESPONSE RD
SACRAMENTO CA
95815-4805
US

V. Phone/Fax

Practice location:
  • Phone: 916-649-1515
  • Fax: 916-649-1516
Mailing address:
  • Phone: 916-649-1515
  • Fax: 916-649-1516

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberA144438
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: