| Doctor Name: | MR. ALAN LEO LIBERMAN |
| NPI Number: | 1033260203 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | DISPENSING OPTICIAN |
| License Number: | D3425 |
| Business Practice Address: | 14210 Palm Dr Suite A2 Desert Hot Springs, CA - 922406873 |
| Business Phone Number: | 7603290528 |
| Business Fax Number: | |
| Mailing Address: | 14210 Palm Dr, Suite A2 DESERT HOT SPRINGS |
| State: | CA |
| Postal Code: | 922406873 |
| Phone Number: | 7603290528 |
| Fax Number: | |
| NPI Enumeration Date: | 01/15/2007 |
| NPI Last Update Date: | 07/09/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 156FX1800X |
| License Number: | D3425 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Eye and Vision Services Providers |
| Taxonomy Classification: | Technician/Technologist |
| Taxonomy Specialization: | Optician |
| Taxonomy Definition: | |