Bo Liu, M.D.

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

A109174 Issued in CA

Practice address

8608 Utica Ave Ste 218
Rancho Cucamonga, CA 91730-4879

Phone

(626) 569-0088

Fax

(866) 443-7567

NPI assigned

Aug 24, 2009

Last updated

Jul 29, 2016By the provider in NPPES

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

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• The Wound Care Doctors

  • Surgery Physician
  • Rancho Cucamonga, CA
  • NPI 1043977184
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1251072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1469750400000",
    "number": "1669605747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8608 UTICA AVE STE 218",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917304879",
            "telephone_number": "626-569-0088",
            "fax_number": "866-443-7567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8608 UTICA AVE STE 218",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917304879",
            "telephone_number": "626-569-0088",
            "fax_number": "866-443-7567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIU",
        "first_name": "BO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-08-24",
        "last_updated": "2016-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "A109174",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CA",
            "license": "A109174",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P01545809",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shin Yin Liong, M.D.
• Earl Liotti, MFT TRAINEE
• Jeffrey Steven Lissy, DDS
• Little Star Healthcare Little Star Pediatric Urgent Care (Little Star Pediatric Urgent Care)
• Andrew Liu, ATC
• Ji Liu
• Jinying Liu
• Living Hope Counseling Center
• David Anthony Lizama
• Vickie L Lizardi

• General Practice Physician in Rancho Cucamonga, CA
• Providers in Rancho Cucamonga, CA by specialty
• General Practice Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2016; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.