Individual provider Active NPI

Wilson Liu, D.O.

  • Internal Medicine Physician
  • Los Angeles, CA
National Provider Identifier
1326496167
Registry record updated Jul 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
20A16858 Issued in CA
Practice address
1711 W Temple St Ste 4691
Los Angeles, CA 90026-7336
Phone
(213) 238-5887
NPI assigned
Jun 2, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 14, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 20A16858 CA Primary

Addresses

Primary practice location

1711 W Temple St Ste 4691
Los Angeles, CA 90026-7336

Mailing address

1711 W Temple St Ste 4691
Los Angeles, CA 90026-7336
Phone (213) 238-5887

Other practice location 1

10800 Knights Rd
Philadelphia, PA 19114-4200
Phone (215) 612-5161

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
I20191104001635 CA Practitioner - Internal Medicine 5890078174 Reassigns benefits to 6 organizations

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
Cedar Springs Hospitalist Medical Group IncGroup PAC ID 6406199868, 26 clinicians

Practice addresses (Care Compare)

1420 S Central Ave
Glendale, CA 91204-2508
Phone (818) 502-1900

Hospital & facility affiliations

  • Glendale Mem Hospital & HLTH Center Hospital, Glendale, CA, CCN 050058

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20A16858CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pih Health Physicians Current Accepting new patients
Pih Health Physicians CurrentSince Jan 1, 2021 Accepting new patients
Caremore Pediatric Hospitalist Medical Group, Inc. CurrentSince Jun 1, 2021 Accepting new patients
Superior Hospitalist Medical Group Inc Internal Medicine CurrentSince Apr 1, 2020 Accepting new patients
Sera Ramadan, D.O., Inc Internal Medicine CurrentSince Jul 16, 2023 Accepting new patients
Cedar Springs Hospitalist Medical Group, Inc. CurrentSince Dec 2, 2022 Accepting new patients
Ca Hospital Hospitalist Medical Group Inc CurrentSince Sep 1, 2019 Accepting new patients
Pih Health Physicians Internal Medicine CurrentSince Jan 1, 2021 Accepting new patients

Locations

1420 S Central Ave
Glendale, CA 91204
Phone (818) 502-1900

222 W Eulalia St
Ste 201
Glendale, CA 91204
Phone (213) 238-5887

12675 La Mirada Blvd
Ste 201401
La Mirada, CA 90638
Phone (562) 903-7339

1720 E Cesar E Chavez Ave
Los Angeles, CA 90033
Phone (323) 260-5781

1711 W Temple St
Ste 4691
Los Angeles, CA 90026
Phone (213) 238-5887

1680 E 120th St
Los Angeles, CA 90059
Phone (424) 338-8000

1401 S Grand Ave
Los Angeles, CA 90015
Phone (213) 742-5555

1225 Wilshire Blvd
Los Angeles, CA 90017
Phone (213) 482-2741

Organizations & group practices 8

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 1

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": "1464825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689292800000",
    "number": "1326496167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1711 W TEMPLE ST STE 4691",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900267336",
            "telephone_number": "213-238-5887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1711 W TEMPLE ST STE 4691",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900267336",
            "telephone_number": "213-238-5887"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10800 Knights Rd",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191144200",
            "country_code": "US",
            "telephone_number": "215-612-5161",
            "fax_number": "215-612-4069",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LIU",
        "first_name": "WILSON",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-06-02",
        "last_updated": "2023-07-14",
        "certification_date": "2023-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "20A16858",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.