NPIMap

Individual provider Active NPI

Samuel S Liu, MD

  • Nephrology Physician
  • Downey, CA
National Provider Identifier
1912935628
Registry record updated Jun 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
A74056 Issued in CA
Practice address
11480 Brookshire Ave Ste 105
Downey, CA 90241-5020
Phone
(562) 862-8184
Fax
(562) 862-8184
NPI assigned
Jun 29, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 28, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X A74056 CA Primary

Addresses

Primary practice location

11480 Brookshire Ave Ste 105
Downey, CA 90241-5020

Mailing address

1122 Volante Dr
Arcadia, CA 91007-6052
Phone (951) 231-0738

Other practice location 1

210 W Bonita Ave Ste 140
Pomona, CA 91767-1866
Phone (951) 231-0738

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051201000591 CA Practitioner - Nephrology 7618997925 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Department of State HospitalsGroup PAC ID 9638174238, 275 clinicians

Practice addresses (Care Compare)

11401 Bloomfield Ave
Norwalk, CA 90650-2015
Phone (916) 651-8811

210 W Bonita Ave
Suite 140
Pomona, CA 91767-1866
Phone (951) 231-6052

Hospital & facility affiliations

  • DaVita Rowland Heights Dialysis Dialysis facility, City of Industry, CA, CCN 552843
  • DaVita Downey Dialysis Center Dialysis facility, Downey, CA, CCN 052574
  • DaVita Pomona Valley Dialysis Dialysis facility, Pomona, CA, CCN 552774
  • DaVita Covina Dialysis Center Dialysis facility, West Covina, CA, CCN 052580
  • DaVita Fontana Dialysis Dialysis facility, Fontana, CA, CCN 052682
  • Pih Health Hospital-Whittier Hospital, Whittier, CA, CCN 050169
  • Pih Health Downey Hospital Hospital, Downey, CA, CCN 050393
  • Pomona Valley Hospital Medical Center Hospital, Pomona, CA, CCN 050231

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A74056CAMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Department of State Hospitals CurrentSince Mar 9, 2019 Accepting new patients
Department of State Hospitals Current Accepting new patients
Department of State Hospitals CurrentSince Mar 9, 2019 Accepting new patients
Casa Colina Hospital and Centers for Healthcare Current Accepting new patients
Ahmc San Gabriel Valley Medical Past Accepting new patients
Royalty Nephrology Medical Group, Inc. Nephrology Past Accepting new patients
Primecare Medical Group Past Accepting new patients
Pih Health Whittier Hospital Past Accepting new patients
San Dimas Community Hospital, Inc. Past Accepting new patients
San Antonio Regional Hospital Past Accepting new patients
Pomona Valley Hospital Medical Center Past Accepting new patients
Pih Health Downey Hospital Past Accepting new patients
Caduceus Physicians Medical Group Past Accepting new patients
Ahmc Whittier Hospital Medical Center LP Past Accepting new patients
Rancho Faculty Medical Associates, Inc. Past Accepting new patients
Usc Arcadia Hospital Past Accepting new patients
Los Alamitos Medical Center, Inc. Past Accepting new patients

Locations

11401 Bloomfield Ave
Norwalk, CA 90650
Phone (562) 863-7011

160 E Artesia St
Ste 225
Pomona, CA 91767
Phone (909) 629-7878

1900 Royalty Dr
Ste 130
Pomona, CA 91767
Phone (909) 623-1561

1600 9th St
Ste 150
Sacramento, CA 95814
Phone (916) 651-8811

1215 O St
#3
Sacramento, CA 95814
Phone (916) 651-2805

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/2708/brand/1/csg/1/fhir/r4
  • Direct secure messaging: casacolina@direct.casacolina.org

Organizations & group practices 18

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.

View all 18

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1151539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719532800000",
    "number": "1912935628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1122 VOLANTE DR",
            "city": "ARCADIA",
            "state": "CA",
            "postal_code": "910076052",
            "telephone_number": "951-231-0738",
            "fax_number": "626-337-6625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11480 BROOKSHIRE AVE STE 105",
            "city": "DOWNEY",
            "state": "CA",
            "postal_code": "902415020",
            "telephone_number": "562-862-8184",
            "fax_number": "562-862-8184"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "210 W Bonita Ave Ste 140",
            "address_purpose": "LOCATION",
            "city": "Pomona",
            "state": "CA",
            "postal_code": "917671866",
            "country_code": "US",
            "telephone_number": "951-231-0738",
            "fax_number": "626-698-4515",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LIU",
        "first_name": "SAMUEL",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-29",
        "last_updated": "2024-06-28",
        "certification_date": "2024-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "CA",
            "license": "A74056",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Downey, CA

Sources for this page

Verify at the official NPI Registry.