Ruth Y Liu, M.D.
Individual provider Active NPI Family Medicine Physician · Dixon, CA
NPI 1295830768 · NPPES record last updated Jul 22, 2015
Key facts
- NPI
- 1295830768
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- G57017 (CA)
- Practice address
- 125 N Lincoln St
#G
Dixon, CA 95620-3258 - Phone
- (707) 678-1623
- Fax
- (707) 678-0258
- NPI assigned
- Sep 13, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20081210000899 | CA | Practitioner - Family Practice | 5698836500 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G57017 | CA | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sutter Valley Medical Foundation | Family Medicine | Current | Accepting new patients |
Locations
600 Coffee Rd
Modesto, CA 95355
Phone (209) 550-4755
2800 L St
Ste 500
Sacramento, CA 95816
Phone (916) 454-6850
Interoperability endpoints
- rliumd11924@hisp.ehr.sutterhealth.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | G57017 | CA | Yes |
Addresses
Primary practice location
125 N Lincoln St
#G
Dixon, CA 95620-3258
Mailing address
10470 Old Placerville Rd
Suite 100
Sacramento, CA 95827-2539
Phone (800) 470-0071
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00G570170 | Medicaid | CA |
Other providers in Dixon, CA
- Belen Alejandra Lastra
- Jennifer Lausier
- Sandra D Lee
- Chunhua Chilton Liu
- Julie Liu
- Adrian Aldemaro Loarca
- Ana Ruth Lobo-Smithson
- Angela Lockwood
- Longs Drug Stores California LLC
- Asmahan Maayeh
All providers in Dixon, CA · Family Medicine Physician in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 22, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.