Alexander Liaw, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

66072 Issued in CA

Practice address

862 Meinecke Ave Ste 200
San Luis Obispo, CA 93405-3704

Phone

(805) 250-1080

NPI assigned

Oct 23, 2023

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dermatology Spa Med IncGroup PAC ID 9830567189, 8 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Marian Regional Medical Center Hospital, Santa Maria, CA, CCN 050107

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• Dermatology Spa Med Inc

  • Dermatology Physician
  • Pismo Beach, CA
  • NPI 1356094676
  Medicare reassignment Care Compare group NPD
• Dignity Health

  • General Acute Care Hospital
  • Santa Maria, CA
  • NPI 1760510937
  NPD (past)
• La Laser Center PC, a Professional Medical Corporation

  • Non-Pharmacy Dispensing Site
  • Turlock, CA
  • NPI 1356974059
  NPD (past)

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

• Dignity Health

  • General Acute Care Hospital
  • Santa Maria, CA
  • NPI 1760510937
  Care Compare affiliation

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

{
    "created_epoch": "1698019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745366400000",
    "number": "1124890132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "862 MEINECKE AVE STE 200",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934053704",
            "telephone_number": "805-250-1080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "862 MEINECKE AVE STE 200",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934053704",
            "telephone_number": "805-250-1080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIAW",
        "first_name": "ALEXANDER",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-10-23",
        "last_updated": "2025-04-23",
        "certification_date": "2025-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "66072",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Martha Treleven Lewis, MFTI
• Nicholas Alan Leyden, BS, MS, CSCS
• Feng Ling Li de Wang, ACUPUNCTURIST
• Kirsten Liana
• Melanie Liantonio-Barnes
• Shelly Licciardi, SLP
• Geneva Mary Licht
• David Chris Lichti, LMFT
• Danny Leroy Lickness, MD
• Life Steps Foundation, Inc.

• Physician Assistant in San Luis Obispo, CA
• Providers in San Luis Obispo, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.