Liberty Medical Group, Inc.

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

G76640 Issued in CA

Legal business name

LIBERTY MEDICAL GROUP, INC.

Doing business as

Liberty Medical Group

Practice address

9227 Haven Avenue, Suite 375
Rancho Cucamonga, CA 91730

Phone

(909) 944-1806

Fax

(909) 466-6593

NPI assigned

Mar 24, 2016

Last updated

Feb 19, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Satish Lal, M.D.

Title

Ceo

Phone

(909) 944-1806

Specialties & licenses 1

Addresses

Other names 1

• Liberty Medical Group Doing business as

Locations

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

{
    "created_epoch": "1458777600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1518998400000",
    "number": "1851753321",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14071 PEYTON DRIVE, #301",
            "city": "CHINO HILLS",
            "state": "CA",
            "postal_code": "91709",
            "telephone_number": "909-944-1806",
            "fax_number": "909-466-6593"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9227 HAVEN AVENUE, SUITE 375",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "91730",
            "telephone_number": "909-944-1806",
            "fax_number": "909-466-6593"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIBERTY MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-24",
        "last_updated": "2018-02-19",
        "status": "A",
        "authorized_official_last_name": "LAL",
        "authorized_official_first_name": "SATISH",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "909-944-1806",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CA",
            "license": "G76640",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Liberty Medical Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• General Practice Physician in Rancho Cucamonga, CA
• Providers in Rancho Cucamonga, CA by specialty
• General Practice Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2018; 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.