Individual provider Active NPI

Geoffrey Liang, D.O.

  • Internal Medicine Physician
  • Mission Hills, CA
National Provider Identifier
1083064091
Registry record updated Aug 28, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
20A17086 Issued in CA
Practice address
11333 Sepulveda Blvd
Mission Hills, CA 91345-1116
Phone
(877) 634-3196
NPI assigned
Jun 21, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 28, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X 20A17086 CA Primary

Addresses

Primary practice location

11333 Sepulveda Blvd
Mission Hills, CA 91345-1116

Mailing address

PO Box 9602
Mission Hills, CA 91346-9602
Phone (818) 837-5559

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190809001133 CA Practitioner - Internal Medicine 2567701386 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Lake Erie College of Osteopathic Medicine, Erie, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Providence Facey Medical FoundationGroup PAC ID 3173436276, 324 clinicians

Practice addresses (Care Compare)

11333 Sepulveda Blvd
Mission Hills, CA 91345-1116
Phone (818) 365-9531

Hospital & facility affiliations

  • Providence Holy Cross Medical Center Hospital, Mission Hills, CA, CCN 050278
  • Henry Mayo Newhall Hospital Hospital, Valencia, CA, CCN 050624

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
17086CAMDMental Health Counselor
20A17086CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Facey Medical Foundation CurrentSince Aug 27, 2019 Accepting new patients
Providence Facey Medical Foundation Internal Medicine CurrentSince Aug 27, 2019 Accepting new patients
Henry Mayo Newhall Memorial Hospital Past Accepting new patients

Locations

File 50670
Los Angeles, CA 90074

11333 Sepulveda Blvd
Mission Hills, CA 91345
Phone (818) 365-9531

18460 Roscoe Blvd
Northridge, CA 91325
Phone (818) 734-3600

19950 Rinaldi St
Ste 103
Porter Ranch, CA 91326
Phone (818) 403-2400

23845 McBean Pkwy
Valencia, CA 91355
Phone (661) 200-2000

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: gliang1044427@oc.providencedirect.org

Organizations & group practices 3

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1466467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566950400000",
    "number": "1083064091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9602",
            "city": "MISSION HILLS",
            "state": "CA",
            "postal_code": "913469602",
            "telephone_number": "818-837-5559",
            "fax_number": "818-792-4793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11333 SEPULVEDA BLVD",
            "city": "MISSION HILLS",
            "state": "CA",
            "postal_code": "913451116",
            "telephone_number": "877-634-3196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIANG",
        "first_name": "GEOFFREY",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-06-21",
        "last_updated": "2019-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "20A17086",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mission Hills, CA

Sources for this page

Verify at the official NPI Registry.