MEDICARE: MARK M LENSKY MD

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	207RC0001X	Clinical Cardiac Electrophysiology Physician	A86838	CA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1558582866	OTHER	CA	MEDICARE

Other Identifiers

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

General Provider Information

NPI Number	:	1558582866
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARK M LENSKY MD

Provider Business Mailing Address
First Line	:	4216 TARZANA ESTATES DR
Second Line	:
City	:	TARZANA
State	:	CA
Zip	:	91356-5447
Country	:	US
Telephone Number	:	818-934-7833
Fax Number	:	562-786-8613

Provider Business Practice Location Address
First Line	:	6245 DE LONGPRE AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90028-8253
Country	:	US
Telephone Number	:	323-462-2271
Fax Number	:

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

Provider Enumeration Date	:	05/02/2007
Last Update Date	:	06/21/2022

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