Provider Demographics
NPI:1407840705
Name:LIU, ALBERT T (MD)
Entity Type:Individual
Prefix:
First Name:ALBERT
Middle Name:T
Last Name:LIU
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:4860 Y ST
Mailing Address - Street 2:STE 2500
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95817-2307
Mailing Address - Country:US
Mailing Address - Phone:916-734-6930
Mailing Address - Fax:916-734-6666
Practice Address - Street 1:4860 Y ST
Practice Address - Street 2:STE 2500
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95817-2307
Practice Address - Country:US
Practice Address - Phone:916-734-6930
Practice Address - Fax:916-734-6666
Is Sole Proprietor?:No
Enumeration Date:2005-09-01
Last Update Date:2012-06-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAG67684207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100203860AMedicaid
KS021038Medicare ID - Type Unspecified
KS100203860AMedicaid
B69215Medicare UPIN