Provider Demographics
NPI:1598775223
Name:LIU, SUSIE M (MD)
Entity Type:Individual
Prefix:DR
First Name:SUSIE
Middle Name:M
Last Name:LIU
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:900 WELCH ROAD
Mailing Address - Street 2:SUITE 202
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94304-1803
Mailing Address - Country:US
Mailing Address - Phone:650-324-8878
Mailing Address - Fax:650-324-8524
Practice Address - Street 1:900 WELCH ROAD
Practice Address - Street 2:SUITE 202
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94304-1803
Practice Address - Country:US
Practice Address - Phone:650-324-8878
Practice Address - Fax:650-324-8524
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-08
Last Update Date:2015-02-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAG067248207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G067248Medicare ID - Type Unspecified
F15882Medicare UPIN