Provider Demographics
NPI:1427004621
Name:LIEBERMAN, RONALD E (MD)
Entity type:Individual
Prefix:DR
First Name:RONALD
Middle Name:E
Last Name:LIEBERMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:2550 NORTH HOLLYWOOD WAY
Mailing Address - Street 2:SUITE 209
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91505-5019
Mailing Address - Country:US
Mailing Address - Phone:818-557-0135
Mailing Address - Fax:818-557-1394
Practice Address - Street 1:1225 WILSHIRE BOULEVARD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90017-2395
Practice Address - Country:US
Practice Address - Phone:213-977-2423
Practice Address - Fax:213-202-7028
Is Sole Proprietor?:No
Enumeration Date:2006-05-26
Last Update Date:2009-11-04
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA83884207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A838840OtherCALOPTIMA
CAA83884OtherBLUE CROSS
CA00A838840Medicaid
CAP00102114OtherGOOD SAMARITAN RAILROAD
CA050126VH95094OtherVALLEY PRES TRAILBLAZER
CA050471CH95094OtherGOOD SAM TRAILBLAZER
CAP00101743OtherVALLEY PRES RAILROAD
CA00A838840OtherBLUE SHIELD
CA00A838840OtherCALOPTIMA
CA050471CH95094OtherGOOD SAM TRAILBLAZER
CAH95094Medicare UPIN
CAP00101743OtherVALLEY PRES RAILROAD