Individual provider Active NPI

Sophie I Liu, DPM

  • Foot & Ankle Surgery Podiatrist
  • San Diego, CA
National Provider Identifier
1013911395
Registry record updated Oct 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
000758 Issued in MO
Practice address
7297 Ronson Rd Ste H
San Diego, CA 92111-1428
Phone
(858) 278-6603
NPI assigned
Jun 2, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X 000758 MO Primary

Addresses

Primary practice location

7297 Ronson Rd Ste H
San Diego, CA 92111-1428

Mailing address

5340 Toscana Way Apt 316
San Diego, CA 92122-5660
Phone (314) 565-2773

Other practice location 1

1475 Kisker Rd
Ste 260
Saint Charles, MO 63304-8788
Phone (636) 928-4447

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
000758MOMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Podiatry Associates Inc Foot & Ankle Surgery PastSince Oct 1, 2016 Accepting new patients
Overland Medical Center Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1117670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602028800000",
    "number": "1013911395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5340 TOSCANA WAY APT 316",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921225660",
            "telephone_number": "314-565-2773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7297 RONSON RD STE H",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921111428",
            "telephone_number": "858-278-6603"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1475 Kisker Rd",
            "address_2": "Ste 260",
            "address_purpose": "LOCATION",
            "city": "Saint Charles",
            "state": "MO",
            "postal_code": "633048788",
            "country_code": "US",
            "telephone_number": "636-928-4447",
            "fax_number": "636-928-4497",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LIU",
        "first_name": "SOPHIE",
        "middle_name": "I",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-02",
        "last_updated": "2020-10-07",
        "certification_date": "2020-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "MO",
            "license": "000758",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.