Healthcare Provider Details

I. General information

NPI: 1316137987
Provider Name (Legal Business Name): YONG LIU M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/30/2007
Last Update Date: 05/20/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

416 16TH AVE
SAN FRANCISCO CA
94118-2812
US

IV. Provider business mailing address

416 16TH AVE
SAN FRANCISCO CA
94118-2812
US

V. Phone/Fax

Practice location:
  • Phone: 415-221-0177
  • Fax:
Mailing address:
  • Phone: 415-221-0177
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA100772
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: