Provider Demographics
NPI:1790890457
Name:LIBERMAN, ORLIN (MD)
Entity Type:Individual
Prefix:
First Name:ORLIN
Middle Name:
Last Name:LIBERMAN
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 1:31822 VILLAGE CENTER ROAD
Mailing Address - Street 2:SUITE 107
Mailing Address - City:WESTLAKE VILLAGE
Mailing Address - State:CA
Mailing Address - Zip Code:91361
Mailing Address - Country:US
Mailing Address - Phone:818-991-0564
Mailing Address - Fax:818-597-9476
Practice Address - Street 1:31822 VILLAGE CENTER ROAD
Practice Address - Street 2:SUITE 107
Practice Address - City:WESTLAKE VILLAGE
Practice Address - State:CA
Practice Address - Zip Code:91361
Practice Address - Country:US
Practice Address - Phone:818-991-0564
Practice Address - Fax:818-597-9476
Is Sole Proprietor?:No
Enumeration Date:2006-08-20
Last Update Date:2010-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG052333207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
B57936Medicare UPIN
G052333Medicare ID - Type Unspecified