Individual provider Active NPI

Carole Ilene Lieberman, M.D.

  • Public Health & General Preventive Medicine Physician
  • Beverly Hills, CA
National Provider Identifier
1720298649
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Public Health & General Preventive Medicine PhysicianTaxonomy code 2083P0901X
License
128409-1 Issued in NY
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, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
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

LicenseStateTypeSpecialty
A34122CAMDForensic Psychiatry Physician
128409-1NYMDForensic 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.

Verify at the official NPI Registry.