Healthcare Provider Details

I. General information

NPI: 1114253457
Provider Name (Legal Business Name): EDWARD LIU ANP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/21/2009
Last Update Date: 08/18/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

356 7TH ST
SAN FRANCISCO CA
94103-4030
US

IV. Provider business mailing address

356 7TH ST
SAN FRANCISCO CA
94103-4030
US

V. Phone/Fax

Practice location:
  • Phone: 628-217-6677
  • Fax: 628-217-6699
Mailing address:
  • Phone: 628-217-6677
  • Fax: 628-217-6699

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberNP19114
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberAP60118946
License Number StateWA
# 3
Primary TaxonomyN
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License NumberPHN74857
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN60118146
License Number StateWA
# 5
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN709195
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: