MEDICARE: DR. MARK LEMBERSKY DPM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213E00000X	Podiatrist	E4057	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1215914841
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARK LEMBERSKY DPM

Provider Business Mailing Address
First Line	:	5225 WHITE OAK AVE
Second Line	:	NUMBER 4
City	:	ENCINO
State	:	CA
Zip	:	91316-2457
Country	:	US
Telephone Number	:	818-881-5295
Fax Number	:

Provider Business Practice Location Address
First Line	:	739 N FAIRFAX AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90046-7261
Country	:	US
Telephone Number	:	818-566-6668
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/23/2005
Last Update Date	:	01/10/2013

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