Active NPI
Carole Ilene Lieberman, M.D.
- Public Health & General Preventive Medicine Physician
- Beverly Hills, CA
National Provider Identifier
1720298649
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Public Health & General Preventive Medicine Physician
- License
- 128409-1
- Practice address
- 204 S Beverly Dr
# 108
Beverly Hills, CA 90212-3800 - Phone
- (310) 278-5433
- Fax
- (310) 457-5335
- NPI assigned
- May 22, 2007
- Last updated
- Sep 11, 2025
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 6
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Public Health & General Preventive Medicine Physician | 2083P0901X | A34122 | CA | |
| Public Health & General Preventive Medicine Physician | 2083P0901X | 128409-1 | NY | Primary |
| Forensic Psychiatry Physician | 2084F0202X | A34122 | CA | |
| Forensic Psychiatry Physician | 2084F0202X | 128409-1 | NY | |
| Psychiatry Physician | 2084P0800X | A34122 | CA | |
| Psychiatry Physician | 2084P0800X | 128409-1 | NY |
Addresses
Primary practice location
204 S Beverly Dr
# 108
Beverly Hills, CA 90212-3800
Mailing address
30765 Pacific Coast Hwy
# 367
Malibu, CA 90265-3646
Phone (310) 457-5441
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A34122 | CA | MD | Forensic Psychiatry Physician |
| 128409-1 | NY | MD | Forensic Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179792000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1757548800000",
"number": "1720298649",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "30765 PACIFIC COAST HWY",
"address_2": "# 367",
"city": "MALIBU",
"state": "CA",
"postal_code": "902653646",
"telephone_number": "310-457-5441",
"fax_number": "310-457-5335"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "204 S BEVERLY DR",
"address_2": "# 108",
"city": "BEVERLY HILLS",
"state": "CA",
"postal_code": "902123800",
"telephone_number": "310-278-5433",
"fax_number": "310-457-5335"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LIEBERMAN",
"first_name": "CAROLE",
"middle_name": "ILENE",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-05-22",
"last_updated": "2025-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "2083P0901X",
"taxonomy_group": "",
"desc": "Preventive Medicine, Public Health & General Preventive Medicine",
"state": "CA",
"license": "A34122",
"primary": false
},
{
"code": "2083P0901X",
"taxonomy_group": "",
"desc": "Preventive Medicine, Public Health & General Preventive Medicine",
"state": "NY",
"license": "128409-1",
"primary": true
},
{
"code": "2084F0202X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Forensic Psychiatry",
"state": "CA",
"license": "A34122",
"primary": false
},
{
"code": "2084F0202X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Forensic Psychiatry",
"state": "NY",
"license": "128409-1",
"primary": false
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "CA",
"license": "A34122",
"primary": false
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "NY",
"license": "128409-1",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Beverly Hills, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.