Individual provider Active NPI

Lide Liu, M.D.

  • Hospitalist Physician
  • Alhambra, CA
National Provider Identifier
1972719557
Registry record updated Sep 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
A96669 Issued in CA
Practice address
1680 S Garfield Ave Ste 204
Alhambra, CA 91801-5413
Phone
(818) 839-5200
Fax
(818) 839-5190
NPI assigned
May 14, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X A96669 CA Primary

Addresses

Primary practice location

1680 S Garfield Ave Ste 204
Alhambra, CA 91801-5413

Mailing address

1680 S Garfield Ave Ste 204
Alhambra, CA 91801-5413
Phone (818) 839-5200

Other practice location 1

3001 Sillect Ave
Bakersfield, CA 93308-6337
Phone (661) 477-9283

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
I20080108000475 CA Practitioner - Internal Medicine 4284714908 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A96669CAMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Astrana Care Hospitalists, a Medical Corporation Hospitalist CurrentSince Sep 1, 2018 Accepting new patients
Coastal Communities Physician Network, Inc. Past Accepting new patients
Adventist Health Physicians Network Past Accepting new patients

Locations

1680 S Garfield Ave
Ste 204
Alhambra, CA 91801
Phone (818) 839-5100

525 N Garfield Ave
Monterey Park, CA 91754
Phone (626) 573-2222

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": "1179100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569542400000",
    "number": "1972719557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1680 S GARFIELD AVE STE 204",
            "city": "ALHAMBRA",
            "state": "CA",
            "postal_code": "918015413",
            "telephone_number": "818-839-5200",
            "fax_number": "818-839-5190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1680 S GARFIELD AVE STE 204",
            "city": "ALHAMBRA",
            "state": "CA",
            "postal_code": "918015413",
            "telephone_number": "818-839-5200",
            "fax_number": "818-839-5190"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3001 Sillect Ave",
            "address_purpose": "LOCATION",
            "city": "Bakersfield",
            "state": "CA",
            "postal_code": "933086337",
            "country_code": "US",
            "telephone_number": "661-477-9283",
            "fax_number": "661-310-9506",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LIU",
        "first_name": "LIDE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-14",
        "last_updated": "2019-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "CA",
            "license": "A96669",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alhambra, CA

Sources for this page

Verify at the official NPI Registry.