Liberty 2000 LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

LIBERTY 2000 LLC

Practice address

10760 Warner Ave
201
Fountain Valley, CA 92708-3845

Phone

(714) 593-5356

Fax

(714) 593-5366

NPI assigned

Nov 19, 2013

Organization subpart

No

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

Authorized official

Name

Mr. Derek Tran, JD

Title

Proprietor

Phone

(714) 306-3013

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Liberty Labs Doing business as

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

{
    "created_epoch": "1384819200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1384819200000",
    "number": "1780014282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10760 WARNER AVE",
            "address_2": "201",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927083845",
            "telephone_number": "714-593-5356",
            "fax_number": "714-593-5366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10760 WARNER AVE",
            "address_2": "201",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927083845",
            "telephone_number": "714-593-5356",
            "fax_number": "714-593-5366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIBERTY 2000 LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-19",
        "last_updated": "2013-11-19",
        "status": "A",
        "authorized_official_last_name": "TRAN",
        "authorized_official_first_name": "DEREK",
        "authorized_official_title_or_position": "PROPRIETOR",
        "authorized_official_telephone_number": "714-306-3013",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "JD"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "05D2057214",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Liberty Labs",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jasmine Iris Li, PA-C
• Xiaodong Li, M.D.
• Yukyin Li, ACUPUNCTRIST
• Christopher David Liao, MD
• Shannon Roxanne Libbrecht, R.D.
• Liberty Laboratory LLC
• Jo Lieberman Pan, MD
• Life Solution Healthcare Services
• Life Solution Hospice Inc
• Jue Liu Lim, O.D.

• Clinical Medical Laboratory in Fountain Valley, CA
• Providers in Fountain Valley, CA by specialty
• Clinical Medical Laboratory in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2013; 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.