1245659598 NPI number — XIN AMY LIAO M.D.

Table of content: XIN AMY LIAO M.D. (NPI 1245659598)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1245659598 NPI number — XIN AMY LIAO M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LIAO
Provider First Name:
XIN
Provider Middle Name:
AMY
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
LIAO
Provider Other First Name:
AMY
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
M.D.
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1245659598
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/07/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1100 VETERANS BLVD.
Provider Second Line Business Mailing Address:
HOSPITAL 2ND FLOOR, HBS WORKROOM
Provider Business Mailing Address City Name:
REDWOOD CITY
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
94063
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1100 VETERANS BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
REDWOOD CITY
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94063-2037
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
650-299-2000
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/15/2014

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X , with the licence number:  A141361 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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