Healthcare Provider Details

I. General information

NPI: 1285082446
Provider Name (Legal Business Name): ANDY LIU MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/28/2016
Last Update Date: 10/15/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2351 CLAY ST SUITE 380
SAN FRANCISCO CA
94115-1931
US

IV. Provider business mailing address

2351 CLAY ST SUITE 380
SAN FRANCISCO CA
94115-1931
US

V. Phone/Fax

Practice location:
  • Phone: 415-600-6000
  • Fax:
Mailing address:
  • Phone: 732-616-1702
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA153687
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: