Provider Demographics
NPI:1619923430
Name:LI, ARTHUR ELIOT (MD)
Entity Type:Individual
Prefix:DR
First Name:ARTHUR
Middle Name:ELIOT
Last Name:LI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 6102
Mailing Address - Street 2:
Mailing Address - City:NOVATO
Mailing Address - State:CA
Mailing Address - Zip Code:94948-6102
Mailing Address - Country:US
Mailing Address - Phone:415-884-3418
Mailing Address - Fax:415-883-0877
Practice Address - Street 1:1501 TROUSDALE DR
Practice Address - Street 2:
Practice Address - City:BURLINGAME
Practice Address - State:CA
Practice Address - Zip Code:94010-4506
Practice Address - Country:US
Practice Address - Phone:650-696-5515
Practice Address - Fax:650-696-5280
Is Sole Proprietor?:No
Enumeration Date:2006-05-25
Last Update Date:2021-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA855132085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A855130Medicaid
CAP00181987OtherRAILROAD MEDICARE
CA00A8551324Medicare PIN
CA00A855138Medicare PIN
CACZ848TMedicare PIN
CACZ848VMedicare PIN
CACZ848XMedicare PIN
CA00A8551317Medicare PIN
CA00A8551310Medicare PIN
CA00A855134Medicare PIN
CACZ848WMedicare PIN
CA00A8551321Medicare PIN
CA00A8551315Medicare PIN
CAP00181987OtherRAILROAD MEDICARE
CA00A855137Medicare PIN
CACZ848YMedicare PIN
CA00A8551320Medicare PIN
CA00A855130Medicaid
CA00A8551323Medicare PIN
CACZ848UMedicare PIN
CAI15094Medicare UPIN
CACZ848ZMedicare PIN