Active NPI
Spencer Liebman, M.D.
- Internal Medicine Physician
- Los Angeles, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- A145473
- Practice address
- 1200 N State St
CT-A7D
Los Angeles, CA 90033-1029 - Phone
- (323) 226-7556
- Fax
- (323) 226-2657
- NPI assigned
- Apr 28, 2015
- Last updated
- Oct 21, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | A145473 | CA | Primary |
| Pediatrics Physician | 208000000X | A145473 | CA |
Addresses
Primary practice location
1200 N State St
CT-A7D
Los Angeles, CA 90033-1029
Mailing address
1200 N State St
CT-A7D
Los Angeles, CA 90033-1029
Phone (323) 226-7556
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| SL3232267556 | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- University of Virginia School of Medicine, 2015
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
2020 Zonal Ave
Los Angeles, CA 90089-9520
2260 Duane St
Los Angeles, CA 90039-3102
335 E Ave I
Lancaster, CA 93535-1916
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A145473 | CA | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| County of Los Angeles | Current | Accepting new patients | |
| County of Los Angeles Auditor Controller | Current | Accepting new patients |
Locations
1000 S Fremont Ave
Bldg A11
Alhambra, CA 91803
Phone (626) 457-4240
335 E Avenue I
Lancaster, CA 93535
Phone (661) 471-4000
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Martin Luther King, Jr. Outpatient Center
- Clinic/Center
- Los Angeles, CA
- NPI 1780877613
-
- Clinic/Center
- Los Angeles, CA
- NPI 1295407401
-
dba High Desert Regional Health Center
- Clinic/Center
- Lancaster, CA
- NPI 1366453045
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Los Angeles General Medical Center
- General Acute Care Hospital
- Los Angeles, CA
- NPI 1598773715
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1430179200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1603238400000",
"number": "1548647605",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1200 N STATE ST",
"address_2": "CT-A7D",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900331029",
"telephone_number": "323-226-7556",
"fax_number": "323-226-2657"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1200 N STATE ST",
"address_2": "CT-A7D",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900331029",
"telephone_number": "323-226-7556",
"fax_number": "323-226-2657"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LIEBMAN",
"first_name": "SPENCER",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-04-28",
"last_updated": "2020-10-21",
"certification_date": "2020-10-21",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "CA",
"license": "A145473",
"primary": true
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "CA",
"license": "A145473",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "SL3232267556",
"state": "CA"
}
],
"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 Oct 21, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.