Individual provider Active NPI

Edwin King Liu, DO

  • Anesthesiology Physician
  • Riverside, CA
National Provider Identifier
1942769906
Registry record updated May 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
OP61374543 Issued in WA
Practice address
4445 Magnolia Ave
Riverside, CA 92501-4135
Phone
(951) 788-3000
NPI assigned
Mar 18, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 31, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X OP61374543 WA Primary
Student in an Organized Health Care Education/Training Program 390200000X 390200000X CA

Addresses

Primary practice location

4445 Magnolia Ave
Riverside, CA 92501-4135

Mailing address

6431 Fannin Street
Suite MSB 5.196
Houston, TX 77030
Phone (713) 500-6223

Other identifiers 1

IdentifierTypeStateIssuer
95500695D75264MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20230712004417 WA Practitioner - Anesthesiology 4688034374 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Touro Un College of Osteopathic Medicine, Vallejo, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rainier Anesthesia Associates PCGroup PAC ID 4284523499, 69 clinicians

Practice addresses (Care Compare)

407 14TH Ave SE
Puyallup, WA 98372-3770
Phone (253) 848-6661

Hospital & facility affiliations

  • Multicare Good Samaritan Hospital Hospital, Puyallup, WA, CCN 500079
  • Multicare Auburn Medical Center Hospital, Auburn, WA, CCN 500015
  • Tacoma General Allenmore Hospital Hospital, Tacoma, WA, CCN 500129
  • Multicare Covington Medical Center Hospital, Covington, WA, CCN 500154

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OP61374543WAMDAnesthesiology Physician
390200000XCAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rainier Anesthesia Associates PC Anesthesiology CurrentSince Jul 29, 2023 Accepting new patients

Locations

17700 SE 272nd St
Kent, WA 98042
Phone (253) 372-6500

407 14th Ave SE
Puyallup, WA 98372
Phone (253) 697-4000

104 27th Ave SE
Puyallup, WA 98374
Phone (253) 770-4099

400 E Pioneer
Ste 101
Puyallup, WA 98372
Phone (253) 445-5828

Organizations & group practices 1

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.

Hospital & facility affiliations 4

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": "1552867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685491200000",
    "number": "1942769906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6431 FANNIN STREET",
            "address_2": "SUITE MSB 5.196",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "77030",
            "telephone_number": "713-500-6223",
            "fax_number": "713-500-6270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4445 MAGNOLIA AVE",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925014135",
            "telephone_number": "951-788-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIU",
        "first_name": "EDWIN",
        "middle_name": "KING",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-18",
        "last_updated": "2023-05-31",
        "certification_date": "2023-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "WA",
            "license": "OP61374543",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CA",
            "license": "390200000X",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "95500695D75264",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverside, CA

Sources for this page

Verify at the official NPI Registry.