Organization Active NPI

Liber Diagnostics Inc

  • Physiological Laboratory
  • Los Angeles, CA
National Provider Identifier
1346401031
Registry record updated Jun 24, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physiological LaboratoryTaxonomy code 293D00000X
Legal business name
LIBER DIAGNOSTICS INC
Practice address
1400 S Hayworth Ave
Suite 200
Los Angeles, CA 90035-4813
Phone
(310) 729-9588
NPI assigned
Jun 24, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Leonid Liberzon
Title
President
Phone
(310) 729-9588

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physiological Laboratory 293D00000X CA Primary

Addresses

Primary practice location

1400 S Hayworth Ave
Suite 200
Los Angeles, CA 90035-4813

Mailing address

1800 S Robertson Blvd
Unit 306
Los Angeles, CA 90035-4359
Phone (310) 729-9588

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090302000272 CA Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 8123184033 Practice locations: Los Angeles, CA

National Provider Directory

National Provider Directory

Locations

1400 S Hayworth Ave
Ste 200
Los Angeles, CA 90035
Phone (310) 729-9588

1800 S Robertson Blvd
Unit 306
Los Angeles, CA 90035

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1214265600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214265600000",
    "number": "1346401031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 S ROBERTSON BLVD",
            "address_2": "UNIT 306",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900354359",
            "telephone_number": "310-729-9588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 S HAYWORTH AVE",
            "address_2": "SUITE 200",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900354813",
            "telephone_number": "310-729-9588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIBER DIAGNOSTICS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-24",
        "last_updated": "2008-06-24",
        "status": "A",
        "authorized_official_last_name": "LIBERZON",
        "authorized_official_first_name": "LEONID",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "310-729-9588"
    },
    "taxonomies": [
        {
            "code": "293D00000X",
            "taxonomy_group": "",
            "desc": "Physiological Laboratory",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.