Look up the most recent NPI and PECOS records

Molly San Si Hsam Liu

Dentist

Dental Providers

5527 Clairemont Mesa Blvd, San Diego, CA 92117-2342

PECOS Enrollment

Based on the most recent information from CMS, provider Molly San Si Hsam Liu does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records yesterday at 12:57 PM.

Profile Details

Provider ID
1467505651
Provider Type
Individual
Full Name
Liu, Molly San Si Hsam
Title
Dr.
Credential
D.D.S.

Gender
Female
Sole Proprietor
Yes
Enumeration Date
1/19/2007
Last Updated
7/8/2007

Contact Information

Practice Location

5527 Clairemont Mesa Blvd, San Diego, CA 92117-2342

(858) 467-0503

(858) 467-9103

Mailing Location

6621 Wesley Pl, San Diego, CA 92120-4825

(619) 469-9473

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 122300000X Primary	Description Dentist Dental Providers	License 41461 California

Provider Identifiers

ID	Description	Issuer
ID G91634-01	Description Medicaid	Issuer Unlisted California

Molly San Si Hsam 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

Espinoza, Michelle M

Huynh And Habashi Dental Corporation

Tarabishi Dds, Inc

Stuart T. Tani Dds, A Dental Corp.

Tyszkowski, Nicole

Taylor, Joyal Wesley

Refahi, Niknam

Aldabe, Ali Mahmoud

Block, Harold

Assadi, Sadaf