Individual provider Active NPI

Peter Liao, MD, PHD

  • Psychiatry Physician
  • Los Angeles, CA
National Provider Identifier
1790312189
Registry record updated Aug 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
A178622 Issued in CA
Practice address
1200 N State Street
Clinic Tower Suite A7D
Los Angeles, CA 90033-1029
Phone
(323) 409-1000
NPI assigned
Mar 25, 2020
Last updated
Aug 29, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X A178622 CA Primary

Addresses

Primary practice location

1200 N State Street
Clinic Tower Suite A7D
Los Angeles, CA 90033-1029

Mailing address

1200 N State Street
Clinic Tower Suite A7D
Los Angeles, CA 90033-1029

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
I20240709003377 CA Practitioner - Psychiatry 7416351523 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Alameda Health SystemGroup PAC ID 3779494521, 597 clinicians

Practice addresses (Care Compare)

2060 Fairmont Dr
Castro Valley, CA 94578-1001
Phone (510) 346-7500

Merit-based Incentive Payment System (MIPS)

Final score
95.17 of 100Reported as group
Quality
86.93
Promoting interoperability
100
Improvement activities
40
Cost
72.6

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine, Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
A178622CAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Alameda Health System CurrentSince Jun 30, 2024 Accepting new patients
Alameda Health System CurrentSince Jun 30, 2024 Accepting new patients
Alameda Health System Current Accepting new patients

Locations

2060 Fairmont Dr
Castro Valley, CA 94578
Phone (510) 346-1300

1411 E 31st St
Oakland, CA 94602
Phone (510) 437-4323

7677 Oakport St
Ste 1200
Oakland, CA 94621
Phone (510) 618-5768

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1585094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693267200000",
    "number": "1790312189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 N STATE STREET",
            "address_2": "CLINIC TOWER SUITE A7D",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900331029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 N STATE STREET",
            "address_2": "CLINIC TOWER SUITE A7D",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900331029",
            "telephone_number": "323-409-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIAO",
        "first_name": "PETER",
        "credential": "MD, PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-25",
        "last_updated": "2023-08-29",
        "certification_date": "2023-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A178622",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.