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General NPI Number Information
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NPI Number | 1801322516
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Entity Type | Individual
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Provider Name | FAEZEH TALEBI LIASI M.D.
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Gender | Female
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Dates
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Enumeration Date | 05/02/2017
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Last Update Date | 07/25/2025
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Provider Practice Location Address
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Address Line | 1620 E 2ND ST STE N
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City | BEAUMONT
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State | CA
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Zip | 92223
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Country | US
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Telephone | 951-845-6500
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Fax | 866-859-0338
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Provider Business Mailing Address
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Address Line | 36867 COOK ST STE 101
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City | PALM DESERT
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State | CA
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Zip | 92211-6064
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Country | US
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Telephone | 760-341-1999
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 300671
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | A159670
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License Number State | CA
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