Healthcare Provider Details

I. General information

NPI: 1982859633
Provider Name (Legal Business Name): CORDELIA LIEBERMAN SOTELO M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CORDELIA C LIEBERMAN M.D.

II. Dates (important events)

Enumeration Date: 11/21/2008
Last Update Date: 08/15/2024
Certification Date: 08/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1777 N BELLFLOWER BLVD STE 210
LONG BEACH CA
90815-4020
US

IV. Provider business mailing address

1777 N BELLFLOWER BLVD STE 210
LONG BEACH CA
90815-4020
US

V. Phone/Fax

Practice location:
  • Phone: 562-248-2999
  • Fax: 562-248-2998
Mailing address:
  • Phone: 562-248-2999
  • Fax: 562-248-2998

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA102437
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: