Healthcare Provider Details

I. General information

NPI: 1578983169
Provider Name (Legal Business Name): ROSA LIU M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/22/2014
Last Update Date: 02/11/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

751 S BASCOM AVE
SAN JOSE CA
95128-2604
US

IV. Provider business mailing address

35694 CHAPLIN DR
FREMONT CA
94536-2524
US

V. Phone/Fax

Practice location:
  • Phone: 408-885-5000
  • Fax:
Mailing address:
  • Phone: 510-304-6465
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: