Provider Demographics
NPI:1366566184
Name:LIU, JUN TING (NP, MSN)
Entity type:Individual
Prefix:MS
First Name:JUN TING
Middle Name:
Last Name:LIU
Suffix:
Gender:F
Credentials:NP, MSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 POTRERO AVE # 4A
Mailing Address - Street 2:SFGH SKILLED NURSING FACILITY
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94110-3518
Mailing Address - Country:US
Mailing Address - Phone:415-206-3028
Mailing Address - Fax:415-206-5105
Practice Address - Street 1:1001 POTRERO AVE # 4A
Practice Address - Street 2:SFGH SKILLED NURSING FACILITY
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94110-3518
Practice Address - Country:US
Practice Address - Phone:415-206-3028
Practice Address - Fax:415-206-5105
Is Sole Proprietor?:No
Enumeration Date:2007-03-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARN526195163WW0101X
CANPF10788363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered163WW0101XNursing Service ProvidersRegistered NurseWomen's Health Care, Ambulatory
Not Answered363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
995944OtherSFGH INTERNAL USE ONLY-COMMERCIAL NUMBER
P32960Medicare UPIN