David M K I Liu, MD, PHD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

C56003 Issued in CA

Practice address

2201 South Ave
South Lake Tahoe, CA 96150-7025

Phone

(530) 543-5623

Fax

(530) 541-5738

NPI assigned

Oct 12, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Doctor of Philosophy

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/JECHBA
• Direct secure messaging: david.liu.p5@direct.mydohc.nextgenshare.com
• Direct secure messaging: david.liu@hawaiihie.medicity.net

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.

• Desert Medical Group, Inc.

  • Family Medicine Physician
  • Palm Springs, CA
  • NPI 1114918612

  Internal Medicine

  Medicare reassignment NPD
• White Memorial Community Health Center

  • Pediatrics Physician
  • Los Angeles, CA
  • NPI 1083003321
  Medicare reassignment NPD
• New Life Health Authority

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Ukiah, CA
  • NPI 1104435734
  NPD
• White Memorial Community Health Center

  • Family Medicine Physician
  • Los Angeles, CA
  • NPI 1649090150

  Pediatrics

  NPD
• Molokai Ohana Health Care, Inc.

  • Federally Qualified Health Center (FQHC)
  • Kaunakakai, HI
  • NPI 1336805621
  NPD (past)

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1441238400000",
    "number": "1700975976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 EMERALD BAY RD",
            "city": "SOUTH LAKE TAHOE",
            "state": "CA",
            "postal_code": "961506207",
            "telephone_number": "530-543-5659",
            "fax_number": "530-541-8723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2201 SOUTH AVE",
            "city": "SOUTH LAKE TAHOE",
            "state": "CA",
            "postal_code": "961507025",
            "telephone_number": "530-543-5623",
            "fax_number": "530-541-5738"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIU",
        "first_name": "DAVID",
        "middle_name": "M K I",
        "credential": "MD, PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-12",
        "last_updated": "2015-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "C56003",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "C56003",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "HI",
            "license": "13414",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "HI",
            "license": "13414",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amelia Marie Lewis
• John Frederick Lewison, MD
• Andi Ley, LCSW
• Wendy Mary Liebler
• Aaron M Lindsey, LCSW
• Live Violence Free
• Miriam Locke, MD
• Lea Kathleen Logal
• Kellie London
• Cherie Long, WHNP

• Pediatrics Physician in South Lake Tahoe, CA
• Providers in South Lake Tahoe, CA by specialty
• Pediatrics Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2015; 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.