Libby Wilson MD Inc

Primary specialty

Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X

License

G18778 Issued in CA

Legal business name

LIBBY WILSON MD INC

Practice address

403 W Adams Blvd
Los Angeles, CA 90007-2664

Phone

(213) 742-1433

Fax

(213) 742-1496

NPI assigned

Jan 20, 2015

Organization subpart

No

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

Authorized official

Name

Libby F Wilson, M.D.

Title

President

Phone

(213) 742-1433

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1421712000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1421712000000",
    "number": "1548659170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "403 W ADAMS BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900072664",
            "telephone_number": "213-742-1433",
            "fax_number": "213-742-1496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "403 W ADAMS BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900072664",
            "telephone_number": "213-742-1433",
            "fax_number": "213-742-1496"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIBBY WILSON MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-20",
        "last_updated": "2015-01-20",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "LIBBY",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "213-742-1433",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "CA",
            "license": "G18778",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G187780",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Linda Ming-Huei Liau, MD
• Kristopher Liban
• Aster Libasu
• Evan Justin Libaw, MD
• Keisha M Libbrecht
• Liber Diagnostics Inc
• Danica Brown Liberman, M.D.
• Roslyn Regina Liberman, P.T.
• Elisabeth Nathasha Libermann
• Libertas College Preparatory

• Plastic and Reconstructive Surgery Physician in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Plastic and Reconstructive Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.