MEDICARE: MIMI LIU MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207W00000X	Ophthalmology Physician	43378	CO
2	207WX0107X	Retina Specialist (Ophthalmology) Physician	0043378	CO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1568469625
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MIMI LIU MD

Provider Business Mailing Address
First Line	:	8101 E LOWRY BLVD STE 210
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80230-7195
Country	:	US
Telephone Number	:	303-261-1600
Fax Number	:	303-261-1601

Provider Business Practice Location Address
First Line	:	850 ENGLEWOOD PKWY STE 200
Second Line	:
City	:	ENGLEWOOD
State	:	CO
Zip	:	80110-7399
Country	:	US
Telephone Number	:	303-261-1600
Fax Number	:	303-261-1601

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/05/2005
Last Update Date	:	03/11/2020

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Directions to “ MIMI LIU MD” Practice Location

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