Healthcare Provider Details

I. General information

NPI: 1588367759
Provider Name (Legal Business Name): TINA LIU DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/24/2023
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6080 N CAREFREE CIR
COLORADO SPRINGS CO
80922-2402
US

IV. Provider business mailing address

PO BOX 800022
KANSAS CITY MO
64180-0022
US

V. Phone/Fax

Practice location:
  • Phone: 719-571-1088
  • Fax: 719-571-1089
Mailing address:
  • Phone: 800-953-0104
  • Fax: 303-765-6670

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberDR.0076777
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: