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NPI Code Detail

MEDICARE: MELIA LEIBERT

MEDICARE: MELIA LEIBERT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1093546251
Entity Type Code : Individual
Provider Name (Legal Business Name) : MELIA LEIBERT
Provider Business Mailing Address
First Line : 14194 ONEIDA CT
Second Line :
City : MOORPARK
State : CA
Zip : 93021-3565
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1212 N VERMONT AVE
Second Line :
City : LOS ANGELES
State : CA
Zip : 90029-1769
Country : US
Telephone Number : 323-443-3225
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/09/2024
Last Update Date : 08/09/2024

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Directions to “ MELIA LEIBERT ” Practice Location

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