NPIMap

Organization Active NPI

WT Health of California LLC

  • Infectious Disease Physician
  • Los Angeles, CA
National Provider Identifier
1063201655
Registry record updated Jul 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
Legal business name
WT HEALTH OF CALIFORNIA LLC
Practice address
11103 Venice Blvd
Los Angeles, CA 90034-6914
Phone
(954) 923-7440
Fax
(954) 923-1299
NPI assigned
May 1, 2025
Last updated
Jul 30, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2026

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

Authorized official

Name
Minghsun Liu, MDNPI 1518096270
Title
Authorized Official
Phone
(310) 570-2198

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease Physician 207RI0200X Primary

Addresses

Primary practice location

11103 Venice Blvd
Los Angeles, CA 90034-6914

Mailing address

PO Box 848373
Los Angeles, CA 90084-8373
Phone (954) 923-7440

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250711000278 CA Part B Supplier - Clinic/Group Practice 4486169398 Receives reassigned benefits from 49 practitioners
Practice locations: Los Angeles, CA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 49

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 49

NPI Registry JSON

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

{
    "created_epoch": "1746057600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1785369600000",
    "number": "1063201655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 848373",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900848373",
            "telephone_number": "954-923-7440",
            "fax_number": "954-923-1299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11103 VENICE BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900346914",
            "telephone_number": "954-923-7440",
            "fax_number": "954-923-1299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WT HEALTH OF CALIFORNIA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-05-01",
        "last_updated": "2026-07-30",
        "certification_date": "2026-07-30",
        "status": "A",
        "authorized_official_last_name": "LIU",
        "authorized_official_first_name": "MINGHSUN",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "310-570-2198",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.