Healthcare Provider Details

I. General information

NPI: 1629064894
Provider Name (Legal Business Name): HOWARD LIEBOWITZ M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/23/2005
Last Update Date: 07/10/2025
Certification Date: 07/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1321 7TH ST STE 300
SANTA MONICA CA
90401-1682
US

IV. Provider business mailing address

1321 7TH ST STE 300
SANTA MONICA CA
90401-1682
US

V. Phone/Fax

Practice location:
  • Phone: 310-393-2333
  • Fax: 310-393-8899
Mailing address:
  • Phone: 310-393-2333
  • Fax: 310-458-0179

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License NumberG37685
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: