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Contact Information

LIBERTY MEDICAL GROUP, INC.
9227 HAVEN AVENUE, SUITE 375
RANCHO CUCAMONGA, CA91730
 Phone: 909-944-1806
 Fax: 909-466-6593
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

General Practice

208D00000X 99 Physician/Undefined Physician type[6]
Indicates primary specialty

NPI Profile & details for LIBERTY MEDICAL GROUP INC · (Female)

NPI Number 1851753321
Status Active
Credentials
Entity Individual
Enumeration date 03/24/2016
Last updated 02/19/2018 - About 8 years ago
Sole proprietor 1 Not specified
Identifiers
  • CA License # G76640
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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