Provider Demographics
NPI:1821529769
Name:LIU, RUIKANG (MD)
Entity type:Individual
Prefix:
First Name:RUIKANG
Middle Name:
Last Name:LIU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:KONG KONG
Other - Middle Name:
Other - Last Name:LIU
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:4256 HACIENDA DR STE 100
Mailing Address - Street 2:
Mailing Address - City:PLEASANTON
Mailing Address - State:CA
Mailing Address - Zip Code:94588-8595
Mailing Address - Country:US
Mailing Address - Phone:925-263-0313
Mailing Address - Fax:
Practice Address - Street 1:4256 HACIENDA DR STE 100
Practice Address - Street 2:
Practice Address - City:PLEASANTON
Practice Address - State:CA
Practice Address - Zip Code:94588-8595
Practice Address - Country:US
Practice Address - Phone:925-263-0313
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-22
Last Update Date:2025-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA333597207QS0010X, 2080S0010X, 208000000X
CAA2021122080S0010X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports Medicine
No2080S0010XAllopathic & Osteopathic PhysiciansPediatricsSports Medicine