Provider Demographics
NPI:1194739797
Name:LIU, JOHN K (MD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:K
Last Name:LIU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:7143 SEVILLE AVE
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON PARK
Mailing Address - State:CA
Mailing Address - Zip Code:90255-4905
Mailing Address - Country:US
Mailing Address - Phone:323-584-9525
Mailing Address - Fax:323-583-6000
Practice Address - Street 1:7143 SEVILLE AVE
Practice Address - Street 2:
Practice Address - City:HUNTINGTON PARK
Practice Address - State:CA
Practice Address - Zip Code:90255-4905
Practice Address - Country:US
Practice Address - Phone:323-584-9525
Practice Address - Fax:323-583-6000
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-28
Last Update Date:2025-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA65778207R00000X, 208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A657780Medicaid
CAG75745Medicare UPIN
CAA65778Medicare ID - Type UnspecifiedMEDICARE