Healthcare Provider Details

I. General information

NPI: 1982929378
Provider Name (Legal Business Name): JUDY LIU M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/29/2010
Last Update Date: 10/31/2024
Certification Date: 10/31/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1801 BUSH ST STE 131D
SAN FRANCISCO CA
94109-5273
US

IV. Provider business mailing address

601 ELMWOOD AVE BOX MED
ROCHESTER NY
14642-0001
US

V. Phone/Fax

Practice location:
  • Phone: 415-942-2499
  • Fax: 415-657-8533
Mailing address:
  • Phone: 585-275-2222
  • Fax: 585-756-5111

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA127472
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: