Individual provider Active NPI

Justin Liu, M.D.

  • Physical Medicine & Rehabilitation Physician
  • Los Gatos, CA
National Provider Identifier
1932102332
Registry record updated Jun 1, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
00A766360 Issued in CA
Practice address
355 Dardanelli Lane
El Camino Hospital Inpatient Rehabilitation Center
Los Gatos, CA 95032
Phone
(408) 866-4030
Fax
(408) 871-7491
NPI assigned
May 31, 2005
Last updated
Jun 1, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 00A766360 CA Primary

Addresses

Primary practice location

355 Dardanelli Lane
El Camino Hospital Inpatient Rehabilitation Center
Los Gatos, CA 95032

Mailing address

1484 Pollard Rd # 492
Los Gatos, CA 95032-1031
Phone (408) 866-4030

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
I20040729001402 CA Practitioner - Physical Medicine and Rehabilitation 6800866468 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
Loma Linda University School of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2105 Forest Ave
San Jose, CA 95128-1425
Phone (408) 947-2500

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
00A766360CAMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Justin Liu MD Professional Medical Corporation Physical Medicine & Rehabilitation CurrentSince Apr 27, 2009 Accepting new patients
Dignity Health CurrentSince Jan 1, 2008 Accepting new patients
UCSF Health Community Hospitals CurrentSince Jan 1, 2008 Accepting new patients
Samsonov M.D. Medical Corporation Past Accepting new patients

Locations

1484 Pollard Rd
Los Gatos, CA 95032
Phone (408) 348-9102

2500 Grant Rd
Mountain View, CA 94040
Phone (650) 903-9500

2235 Hayes St
Fl 5
San Francisco, CA 94117
Phone (415) 750-5500

450 Stanyan St
San Francisco, CA 94117
Phone (415) 668-1000

450 Stanyan St
Ste 658
San Francisco, CA 94117
Phone (415) 750-5762

2105 Forest Ave
San Jose, CA 95128
Phone (408) 947-2500

1601 Ygnacio Valley Rd
Walnut Creek, CA 94598
Phone (925) 295-1545

1839 Ygnacio Valley Rd
Walnut Creek, CA 94598
Phone (415) 952-5319

Organizations & group practices 4

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.

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": "1117497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1338508800000",
    "number": "1932102332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1484 POLLARD RD # 492",
            "city": "LOS GATOS",
            "state": "CA",
            "postal_code": "950321031",
            "telephone_number": "408-866-4030",
            "fax_number": "408-871-7491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "355 DARDANELLI LANE",
            "address_2": "EL CAMINO HOSPITAL INPATIENT REHABILITATION CENTER",
            "city": "LOS GATOS",
            "state": "CA",
            "postal_code": "95032",
            "telephone_number": "408-866-4030",
            "fax_number": "408-871-7491"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIU",
        "first_name": "JUSTIN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-31",
        "last_updated": "2012-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "CA",
            "license": "00A766360",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Gatos, CA

Sources for this page

Verify at the official NPI Registry.