Provider Demographics
NPI:1932103827
Name:LIEM, L. BING (DO)
Entity Type:Individual
Prefix:
First Name:L.
Middle Name:BING
Last Name:LIEM
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2490 HOSPITAL DR
Mailing Address - Street 2:SUITE 311
Mailing Address - City:MOUNTAIN VIEW
Mailing Address - State:CA
Mailing Address - Zip Code:94040-4122
Mailing Address - Country:US
Mailing Address - Phone:650-962-4690
Mailing Address - Fax:650-962-4696
Practice Address - Street 1:2490 HOSPITAL DR
Practice Address - Street 2:SUITE 311
Practice Address - City:MOUNTAIN VIEW
Practice Address - State:CA
Practice Address - Zip Code:94040-4122
Practice Address - Country:US
Practice Address - Phone:650-962-4690
Practice Address - Fax:650-962-4696
Is Sole Proprietor?:No
Enumeration Date:2005-06-08
Last Update Date:2011-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMA-1260-04207RC0000X, 207RC0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM63709830Medicaid
NM341415706Medicare PIN
NM63709830Medicaid