Individual provider Active NPI

David Ken Wah Lieu, M.D.

  • Cytopathology Physician
  • Alhambra, CA
National Provider Identifier
1912966680
Registry record updated Mar 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cytopathology PhysicianTaxonomy code 207ZC0500X
License
G42121 Issued in CA
Practice address
320 S Garfield Ave
# 278
Alhambra, CA 91801-3886
Phone
(626) 281-7800
Fax
(626) 281-7802
NPI assigned
Mar 21, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 3, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cytopathology Physician 207ZC0500X G42121 CA Primary
Family Medicine Physician 207Q00000X G42121 CA

Addresses

Primary practice location

320 S Garfield Ave
# 278
Alhambra, CA 91801-3886

Mailing address

320 S Garfield Ave
# 278
Alhambra, CA 91801-3886
Phone (626) 288-7800

Other identifiers 1

IdentifierTypeStateIssuer
00G421211MedicaidCA

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
I20050720001114 CA Practitioner - PathologyPractitioner - General Practice 6800823857 Practice locations: Alhambra, CA; Los Alamitos, CA

Care Compare profile

Medicare Care Compare
Specialty
PathologyAlso: General Practice
Education
University of California, Irvine, California College of Medicine, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

10861 Cherry St
Suite 202
Los Alamitos, CA 90720-5403
Phone (562) 430-9990

320 Garfield Ave
Suite 278
Alhambra, CA 91801
Phone (626) 281-7800

320 So Garfield Ave
Suite 278
Alhambra, CA 91801

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G42121CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
David KW Lieu CurrentSince Jul 25, 2005 Accepting new patients
Ahmc Garfield Medical Center LP Past Accepting new patients
Ahmc Monterey Park Hospital LP Past Accepting new patients

Locations

320 S Garfield Ave
Ste 278
Alhambra, CA 91801
Phone (626) 281-7800

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1142899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204502400000",
    "number": "1912966680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 S GARFIELD AVE",
            "address_2": "# 278",
            "city": "ALHAMBRA",
            "state": "CA",
            "postal_code": "918013886",
            "telephone_number": "626-288-7800",
            "fax_number": "626-288-7802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 S GARFIELD AVE",
            "address_2": "# 278",
            "city": "ALHAMBRA",
            "state": "CA",
            "postal_code": "918013886",
            "telephone_number": "626-281-7800",
            "fax_number": "626-281-7802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIEU",
        "first_name": "DAVID",
        "middle_name": "KEN WAH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-21",
        "last_updated": "2008-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZC0500X",
            "taxonomy_group": "",
            "desc": "Pathology, Cytopathology",
            "state": "CA",
            "license": "G42121",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G42121",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G421211",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Alhambra, CA

Sources for this page

Verify at the official NPI Registry.