MEDICARE: DR. STEVEN SI 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	207L00000X	Anesthesiology Physician	A110988	CA
2	207LP2900X	Pain Medicine (Anesthesiology) Physician	A110988	CA
3	208VP0014X	Interventional Pain Medicine Physician	A110988	CA

General Provider Information

NPI Number	:	1952467698
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STEVEN SI LIU MD

Provider Business Mailing Address
First Line	:	4626 WILLOW RD STE 200
Second Line	:
City	:	PLEASANTON
State	:	CA
Zip	:	94588-8564
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4626 WILLOW RD STE 200
Second Line	:
City	:	PLEASANTON
State	:	CA
Zip	:	94588-8564
Country	:	US
Telephone Number	:	866-623-7600
Fax Number	:

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

Provider Enumeration Date	:	12/28/2006
Last Update Date	:	10/06/2017

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