Provider Demographics
NPI:1790863884
Name:LIU, SAMUEL KWONG-MING (MD)
Entity type:Individual
Prefix:
First Name:SAMUEL
Middle Name:KWONG-MING
Last Name:LIU
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 1:5565 W LAS POSITAS BLVD STE 260
Mailing Address - Street 2:
Mailing Address - City:PLEASANTON
Mailing Address - State:CA
Mailing Address - Zip Code:94588-5807
Mailing Address - Country:US
Mailing Address - Phone:925-416-5470
Mailing Address - Fax:
Practice Address - Street 1:5565 W LAS POSITAS BLVD STE 260
Practice Address - Street 2:
Practice Address - City:PLEASANTON
Practice Address - State:CA
Practice Address - Zip Code:94588-5807
Practice Address - Country:US
Practice Address - Phone:925-416-5470
Practice Address - Fax:925-734-0517
Is Sole Proprietor?:No
Enumeration Date:2006-11-02
Last Update Date:2025-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG64755208C00000X, 208M00000X, 208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal Surgery
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G647550Medicaid
CA00G647550Medicaid
F11682Medicare UPIN