Individual provider Active NPI

Fangluo Liu, M.D.

  • Anatomic Pathology & Clinical Pathology Physician
  • Bakersfield, CA
National Provider Identifier
1124015656
Registry record updated May 18, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
A53049 Issued in CA
Practice address
6501 Truxtun Ave
Bakersfield, CA 93309-0633
Phone
(661) 322-2206
Fax
(661) 327-7027
NPI assigned
Sep 30, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 18, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X A53049 CA Primary

Addresses

Primary practice location

6501 Truxtun Ave
Bakersfield, CA 93309-0633

Mailing address

10710 Harpenden Ave
Bakersfield, CA 93311-3517

Other identifiers 1

IdentifierTypeStateIssuer
A53049OtherCALICENSE

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
I20050628001370 CA Practitioner - Pathology 0042256208 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
South Valley Pathology Associates 2 clinicians

Practice addresses (Care Compare)

420 34TH St
Bakersfield, CA 93301-2237
Phone (661) 327-4647

Hospital & facility affiliations

  • Bakersfield Memorial Hospital Hospital, Bakersfield, CA, CCN 050036
  • Adventist Health Bakersfield Hospital, Bakersfield, CA, CCN 050455

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A53049CAMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kern County Hospital Authority CurrentSince Aug 28, 2023 Accepting new patients
South Valley Pathology Associates Anatomic Pathology & Clinical Pathology CurrentSince Jul 4, 2010 Accepting new patients
Kern County Hospital Authority CurrentSince Aug 28, 2023 Accepting new patients

Locations

420 34th St
Bakersfield, CA 93301
Phone (661) 324-4647

1700 Mount Vernon Ave
Bakersfield, CA 93306
Phone (616) 326-2000

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": "1128038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1495065600000",
    "number": "1124015656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10710 HARPENDEN AVE",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933113517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6501 TRUXTUN AVE",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933090633",
            "telephone_number": "661-322-2206",
            "fax_number": "661-327-7027"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIU",
        "first_name": "FANGLUO",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-30",
        "last_updated": "2017-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "CA",
            "license": "A53049",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "A53049",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bakersfield, CA

Sources for this page

Verify at the official NPI Registry.