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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.

NPI # 1851753321
LBN Legal business name LIBERTY MEDICAL GROUP, INC.
Authorized official SATISH LAL - (CEO)
Entity Organization
Organization subpart 1 No
Enumeration date 03/24/2016
Last updated 02/19/2018 - About 8 years ago
Identifiers
CA License # G76640
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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