Physician Compare National (NPI:1396792750)

HEALTHCARE PROVIDER: SOEN BOEN LIONG M.D.

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1396792750
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	1254477763
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20091013000629
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	LIONG
	Individual professional last name
Provider First Name	SOEN BOEN
	Individual professional first name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	1962
	Individual professional's medical school graduation year
Primary Specialty	DIAGNOSTIC RADIOLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	401 E SPRUCE ST
	Group Practice or individual's line 1 address
City	GARDEN CITY
	Group Practice or individual's city
State	KS
	Group Practice or individual's state
Zip Code	678465679
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	170023
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	ST CATHERINE HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	171359
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	GREELEY COUNTY HEALTH SERVICES
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	170110
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	BOB WILSON MEMORIAL GRANT COUNTY HOSPITAL
	Legal business name of hospital where individual professional provides service 3
Hospital Affiliation CCN 4	171306
	Medicare CCN of hospital where individual professional provides service 4
Hospital Affiliation LBN 4	WICHITA COUNTY HEALTH CENTER
	Legal business name of hospital where individual professional provides service 4
Hospital Affiliation CCN 5	171313
	Medicare CCN of hospital where individual professional provides service 5
Hospital Affiliation LBN 5	KEARNY COUNTY HOSPITAL
	Legal business name of hospital where individual professional provides service 5
Professional Accepts Medicare Assignment	Y

Physician Compare National (NPI:1396792750)

HEALTHCARE PROVIDER: SOEN BOEN LIONG M.D.

Individual Professional Information

Medical School Information

Practice Information

Hospital(s) Affiliation Information