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Lawrence Wayne Liu

Internal Medicine

Allopathic & Osteopathic Physicians

1245 16th St Ste 204, Santa Monica, CA 90404-1240

PECOS Enrollment

This provider is enrolled in PECOS as LAWRENCE LIU.

Based on the most recent information from CMS, provider Lawrence Wayne Liu is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1255890380
Provider Type
Individual
Full Name
Liu, Lawrence Wayne
Credential
MD

Gender
Male
Sole Proprietor
No
Enumeration Date
3/18/2019
Last Updated
12/30/2024

Contact Information

Practice Location

1245 16th St Ste 204, Santa Monica, CA 90404-1240

(310) 319-4141

Unlisted Fax

Mailing Location

5767 W Century Blvd Ste 400, Los Angeles, CA 90045-5631

(310) 301-5200

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 207R00000X Primary	Description Internal Medicine Allopathic & Osteopathic Physicians	License A178663 California

Provider Identifiers

ID	Description	Issuer
ID 2019022527	Description Other	Issuer MISSOURI MEDICAL BOARD Missouri

Lawrence Wayne Liu

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

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Mcgowan, Mark Scheer

Messina, Alex John

Weimer, Amy K

Patanwala, Maria Yousuf

Shi, Audrey

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Wang, Serena Ke Jun

Simpler, Laura Diane

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