Individual provider Active NPI

Corinna Liu, D.O.

  • Gynecologic Oncology Physician
  • Fresno, CA
National Provider Identifier
1083972426
Registry record updated Mar 13, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecologic Oncology PhysicianTaxonomy code 207VX0201X
License
20A13154 Issued in CA
Practice address
290 N Wayte LN
Fresno, CA 93701-2124
Phone
(559) 459-5755
NPI assigned
Apr 23, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 20A13154 CA
Gynecologic Oncology Physician 207VX0201X 20A13154 CA Primary

Addresses

Primary practice location

290 N Wayte LN
Fresno, CA 93701-2124

Mailing address

2625 E Divisadero St
Fresno, CA 93721-1431
Phone (559) 443-2682

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
I20161114000739 CA Practitioner - Obstetrics/Gynecology 9133408248 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Omni Womens Health Medical Group IncGroup PAC ID 4082606009, 4 clinicians

Practice addresses (Care Compare)

2210 E Illinois Ave
Suite 406
Fresno, CA 93701-2184
Phone (559) 486-8888

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20A13154CAMDObstetrics & Gynecology Physician
13154CAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Omni Women'S Health Medical Group, Inc CurrentSince Oct 2, 2016 Accepting new patients
Omni Womens Health Medical Group Inc CurrentSince Oct 2, 2016 Accepting new patients
University Faculty Associates, Inc. Obstetrics & Gynecology CurrentSince Dec 17, 2016 Accepting new patients
Central California Faculty Medical Group, Inc. Current Accepting new patients
Central California Faculty Medical Group, Inc. Obstetrics & Gynecology CurrentSince Dec 1, 2024 Accepting new patients

Locations

1530 Shaw Ave
Clovis, CA 93611
Phone (559) 323-9133

2137 Herndon Ave
Ste 102
Clovis, CA 93611
Phone (559) 466-7100

2137 Herndon Ave
Clovis, CA 93611

2210 E Illinois Ave
Ste 201
Fresno, CA 93701
Phone (559) 266-2496

3812 N 1st St
Fresno, CA 93726
Phone (559) 226-2722

2550 Merced St
Fresno, CA 93721
Phone (209) 233-2116

2335 E Kashian Ln
Ste 240
Fresno, CA 93701
Phone (559) 320-0545

2625 E Divisadero St
Fresno, CA 93721
Phone (559) 453-5200

2823 Fresno St
Fresno, CA 93721
Phone (559) 459-3965

2210 E Illinois Ave
Ste 406
Fresno, CA 93701
Phone (559) 313-9959

2335 E Kashian Ln
Ste 410
Fresno, CA 93701
Phone (559) 266-4100

2944 Fresno St
Fresno, CA 93721
Phone (559) 497-7900

290 N Wayte Ln
Fresno, CA 93701
Phone (559) 459-4101

Organizations & group practices 5

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": "1335139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489363200000",
    "number": "1083972426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2625 E DIVISADERO ST",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937211431",
            "telephone_number": "559-443-2682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "290 N WAYTE LN",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937012124",
            "telephone_number": "559-459-5755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIU",
        "first_name": "CORINNA",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-23",
        "last_updated": "2017-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "20A13154",
            "primary": false
        },
        {
            "code": "207VX0201X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecologic Oncology",
            "state": "CA",
            "license": "20A13154",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

Verify at the official NPI Registry.