Doctor Name: | DAGMAR I LIEPA |
NPI Number: | 1881742047 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MD |
License Number: | G47889 |
Business Practice Address: | 14860 Roscoe Blvd Suite 307 Panorama City, CA - 914024665 |
Business Phone Number: | 8189049008 |
Business Fax Number: | 8189944491 |
Mailing Address: | 14860 Roscoe Blvd, Suite 307 PANORAMA CITY |
State: | CA |
Postal Code: | 914024665 |
Phone Number: | 8189049008 |
Fax Number: | 8189944491 |
NPI Enumeration Date: | 01/06/2007 |
NPI Last Update Date: | 08/19/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | G47889 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |