Individual ProviderPeter LiaoPsychiatry & NeurologyAllopathic & Osteopathic PhysiciansPractice Address1200 N State Street, Clinic Tower Suite A7d, Los Angeles, CA 90033-1029(323) 409-1000PECOS EnrollmentBased on the most recent information from CMS, provider Peter Liao is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1790312189Provider TypeIndividualFull NameLiao, PeterCredentialMD, PHDGenderMaleSole ProprietorNoEnumeration Date3/25/2020Last Updated8/29/2023Contact InformationPractice LocationPractice Address1200 N State Street, Clinic Tower Suite A7d, Los Angeles, CA 90033-1029Phone(323) 409-1000FaxUnlisted FaxMailing LocationMailing Address1200 N State Street, Clinic Tower Suite A7d, Los Angeles, CA 90033-1029PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode2084P0800XPrimaryDescriptionPsychiatry & NeurologyAllopathic & Osteopathic PhysiciansLicenseA178622California