Lieberman Pan, Jo

Lieberman Pan, Jo is an individual health care provider with primary practice located at 11420 Warner Ave , Fountain Valley CA 92708-2529. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Lieberman Pan, Jo can be contacted via phone (714) 549-1300.

Contact Information

Primary practice address
11420 Warner Ave Fountain Valley CA 92708-2529
Phone: (714) 549-1300
Fax: (714) 433-3100
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X A77902 California

Profile Details

NPI number 1598756090
LBN Legal business name Lieberman Pan, Jo
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 2nd, 2005
Last updated Mar 31st, 2011 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1598756090 NPPES
California MEDICAID 00A779020

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