Healthcare Provider Details

I. General information

NPI: 1205422789
Provider Name (Legal Business Name): DL PROFESSIONAL SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/18/2020
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8405 E BASELINE RD STE 104
MESA AZ
85209-4376
US

IV. Provider business mailing address

8405 E BASELINE RD STE 104
MESA AZ
85209-4376
US

V. Phone/Fax

Practice location:
  • Phone: 480-674-3295
  • Fax: 725-239-7974
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. MICHAEL LEHRER
Title or Position: PHYSICIAN OWNER
Credential: MD
Phone: 480-674-3295