MEDICARE: PACIFIC HOSPITALISTS, INC.

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	207R00000X	Internal Medicine Physician
2	207R00000X	Internal Medicine Physician	G77541	CA

General Provider Information

NPI Number	:	1992752562
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PACIFIC HOSPITALISTS, INC.

Provider Business Mailing Address
First Line	:	1318 E FLORENCE AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90001-1935
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1318 E FLORENCE AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90001-1935
Country	:	US
Telephone Number	:	323-584-9525
Fax Number	:	323-583-6000

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. JOHN LIU
Credential	:
Telephone Number	:	323-584-9525

Provider Enumeration Date	:	05/28/2006
Last Update Date	:	08/22/2020

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