Individual provider Active NPI

Alex Corbin Liu, O.D.

  • Optometrist
  • Rowland Heights, CA
National Provider Identifier
1790795318
Registry record updated Dec 26, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
12329T Issued in CA
Practice address
19735 Colima Rd
#4
Rowland Heights, CA 91748-3227
Phone
(909) 468-4622
Fax
(909) 468-4603
NPI assigned
Aug 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 26, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 12329T CA Primary

Addresses

Primary practice location

19735 Colima Rd
#4
Rowland Heights, CA 91748-3227

Mailing address

19735 Colima Rd
#4
Rowland Heights, CA 91748-3227
Phone (909) 468-4622

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130201000234 CA Practitioner - Optometry 6204080088 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12329TCAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Alex Corbin Liu, OD. Inc. Optometrist CurrentSince Jan 1, 2013 Accepting new patients
Nelson & Endicott an Optometric Corporation Optometrist PastSince Apr 8, 2018 Accepting new patients

Locations

19735 Colima Rd
Ste 4
Rowland Heights, CA 91748
Phone (626) 823-3494

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1154995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1356480000000",
    "number": "1790795318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19735 COLIMA RD",
            "address_2": "#4",
            "city": "ROWLAND HEIGHTS",
            "state": "CA",
            "postal_code": "917483227",
            "telephone_number": "909-468-4622",
            "fax_number": "909-468-4603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19735 COLIMA RD",
            "address_2": "#4",
            "city": "ROWLAND HEIGHTS",
            "state": "CA",
            "postal_code": "917483227",
            "telephone_number": "909-468-4622",
            "fax_number": "909-468-4603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIU",
        "first_name": "ALEX",
        "middle_name": "CORBIN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-08",
        "last_updated": "2012-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "12329T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rowland Heights, CA

Sources for this page

Verify at the official NPI Registry.