MEDICARE: BARRY S. LIEBERMAN M.D

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
1	2084P0800X	Psychiatry Physician	A22616	CA

General Provider Information

NPI Number	:	1831108117
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BARRY S. LIEBERMAN M.D

Provider Business Mailing Address
First Line	:	7862 WOODROW WILSON DR
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90046-1256
Country	:	US
Telephone Number	:	310-274-2284
Fax Number	:

Provider Business Practice Location Address
First Line	:	7862 WOODROW WILSON DR
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90046-1256
Country	:	US
Telephone Number	:	310-274-2284
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/05/2006
Last Update Date	:	01/21/2021

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