Provider Demographics
NPI:1962438622
Name:LIEBLER, JANICE (MD)
Entity type:Individual
Prefix:DR
First Name:JANICE
Middle Name:
Last Name:LIEBLER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 31309
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90031-0309
Mailing Address - Country:US
Mailing Address - Phone:323-442-5100
Mailing Address - Fax:
Practice Address - Street 1:1520 SAN PABLO ST
Practice Address - Street 2:SUITE 1000
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90033-5310
Practice Address - Country:US
Practice Address - Phone:323-442-5100
Practice Address - Fax:323-442-5641
Is Sole Proprietor?:No
Enumeration Date:2006-06-24
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG85465207RP1001X, 207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G854650Medicaid
CACE1617OtherGROUP RAILROAD MEDICARE
CA1902846306OtherGROUP NPI
CAW11675OtherGROUP MEDICARE PIN
CA0G0854650OtherBLUE SHIELD
CA00G854650197OtherCAL OPTIMA
CA290012325OtherRAILROAD MEDICARE
CAGR0016910OtherGROUP MEDICAID PIN
CAW18762OtherMEDICARE GROUP ID
CA1356390009OtherGROUP NPI
CAGR0100430OtherGROUP MEDICAL
CA1902846306OtherGROUP NPI
CAC93153Medicare UPIN