Active NPI
Liber Diagnostics Inc
- Physiological Laboratory
- Los Angeles, CA
National Provider Identifier
1346401031
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physiological Laboratory
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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 ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20090302000272 | CA | Part B Supplier - Independent Diagnostic Testing Facility (Idtf) | 8123184033 | Practice locations: Los Angeles, CA |
National Provider Directory
National Provider DirectoryLocations
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.
-
- Diagnostic Radiology Physician
- Beverly Hills, CA
- NPI 1992927719
-
- Diagnostic Radiology Physician
- Los Angeles, CA
- NPI 1902858368
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.