Provider Demographics
NPI:1720298649
Name:LIEBERMAN, CAROLE ILENE (MD)
Entity type:Individual
Prefix:DR
First Name:CAROLE
Middle Name:ILENE
Last Name:LIEBERMAN
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:30765 PACIFIC COAST HWY
Mailing Address - Street 2:# 367
Mailing Address - City:MALIBU
Mailing Address - State:CA
Mailing Address - Zip Code:90265-3646
Mailing Address - Country:US
Mailing Address - Phone:310-457-5441
Mailing Address - Fax:310-457-5335
Practice Address - Street 1:204 S BEVERLY DR
Practice Address - Street 2:# 108
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90212-3800
Practice Address - Country:US
Practice Address - Phone:310-278-5433
Practice Address - Fax:310-457-5335
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-22
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
CAA341222083P0901X, 2084F0202X, 2084P0800X
NY128409-12083P0901X, 2084F0202X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine
Not Answered2084F0202XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyForensic Psychiatry
Not Answered2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry