Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mr. Alexander Liaw, PA-C

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1124890132

Mr. Alexander Liaw, PA-C is a Physician Assistant in San Luis Obispo, California. Qualified in 2024, 2 years ago. Practices with Dermatology Spa Med Inc, a 7-clinician group and accepts Medicare assignment. Licensed in California.

Years since qualifying
2
Licensed in
CA
In the registry since
2023
Specialties on file
2
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

862 Meinecke Ave Ste 200
San Luis Obispo, CA 93405-3704
Phone: (805) 250-1080
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 66072 (CA)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1124890132
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorYes
NPI enumeratedOctober 23, 2023
Last updated in NPPESApril 23, 2025
Certification dateApril 23, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Group practice Dermatology Spa Med Inc — 7 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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