Individual provider Active NPI

Annie Wang Liu

  • Pharmacist
  • Los Angeles, CA
National Provider Identifier
1962931238
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
69134 Issued in CA
Practice address
4414 York Blvd
Los Angeles, CA 90041
Phone
(323) 344-4443
Fax
(323) 344-4449
NPI assigned
Jun 8, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 69134 CA Primary

Addresses

Primary practice location

4414 York Blvd
Los Angeles, CA 90041

Mailing address

4414 York Blvd
Los Angeles, CA 90041-3328
Phone (323) 344-4443

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
69134CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Longs Drug Store California LLC PastSince Jul 24, 2022 Accepting new patients
Longs Drug Stores California LLC PastSince Jul 24, 2022 Accepting new patients

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": "1496880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1962931238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4414 YORK BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900413328",
            "telephone_number": "323-344-4443",
            "fax_number": "323-344-4449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4414 YORK BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90041",
            "telephone_number": "323-344-4443",
            "fax_number": "323-344-4449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIU",
        "first_name": "ANNIE",
        "middle_name": "WANG",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-06-08",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "69134",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.