Provider Demographics
NPI:1982859633
Name:SOTELO, CORDELIA LIEBERMAN (MD)
Entity Type:Individual
Prefix:DR
First Name:CORDELIA
Middle Name:LIEBERMAN
Last Name:SOTELO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:CORDELIA
Other - Middle Name:C
Other - Last Name:LIEBERMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:4910 AIRPORT PLAZA DR
Mailing Address - Street 2:STE 210
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90815-1377
Mailing Address - Country:US
Mailing Address - Phone:562-421-3727
Mailing Address - Fax:
Practice Address - Street 1:4910 AIRPORT PLAZA DR STE 210
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90815-1377
Practice Address - Country:US
Practice Address - Phone:562-421-3727
Practice Address - Fax:562-420-8948
Is Sole Proprietor?:No
Enumeration Date:2008-11-21
Last Update Date:2021-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA102437207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACT400YMedicare PIN