Individual provider Active NPI

Ronghuan Liu, MD

  • Anesthesiology Physician
  • Riverside, CA
National Provider Identifier
1841333960
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
A72410 Issued in CA
Practice address
6969 Brockton Ave
Suite B
Riverside, CA 92506-3813
Phone
(951) 686-3575
Fax
(951) 781-2194
NPI assigned
Feb 15, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X A72410 CA Primary

Addresses

Primary practice location

6969 Brockton Ave
Suite B
Riverside, CA 92506-3813

Mailing address

6969 Brockton Ave
Suite B
Riverside, CA 92506-3813
Phone (951) 686-3575

Other identifiers 1

IdentifierTypeStateIssuer
00A24100MedicaidCA

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
I20101222000517 CA Practitioner - Anesthesiology 1052509767 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A72410CAMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wang Jennifer Zheng M D Inc Anesthesiology CurrentSince Apr 16, 2022 Accepting new patients
Golden State Providers, a Medical Corporation CurrentSince Jan 13, 2022 Accepting new patients

Locations

1117 E Devonshire Ave
Hemet, CA 92543
Phone (951) 652-2811

4445 Magnolia Ave
Riverside, CA 92501
Phone (800) 498-7156

3865 Jackson St
Riverside, CA 92503
Phone (909) 688-2211

4510 Brockton Ave
Ste 175
Riverside, CA 92501
Phone (951) 786-5100

2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426

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": "1171497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1841333960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6969 BROCKTON AVE",
            "address_2": "SUITE B",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925063813",
            "telephone_number": "951-686-3575",
            "fax_number": "951-781-2194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6969 BROCKTON AVE",
            "address_2": "SUITE B",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925063813",
            "telephone_number": "951-686-3575",
            "fax_number": "951-781-2194"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIU",
        "first_name": "RONGHUAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "A72410",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A24100",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverside, CA

Sources for this page

Verify at the official NPI Registry.