Healthcare Provider Details
I. General information
NPI: 1912263641
Provider Name (Legal Business Name): WARREN M. LENT MD INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/06/2012
Last Update Date: 04/06/2012
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
150 N ROBERTSON BLVD STE 140
BEVERLY HILLS CA
90211-2143
US
IV. Provider business mailing address
150 N ROBERTSON BLVD STE 140
BEVERLY HILLS CA
90211-2143
US
V. Phone/Fax
- Phone: 310-652-6500
- Fax:
- Phone: 310-652-6500
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208200000X |
| Taxonomy | Plastic Surgery Physician |
| License Number | G71805 |
| License Number State | CA |
VIII. Authorized Official
Name:
WARREN
LENT
Title or Position: PRESIDENT
Credential: MD
Phone: 310-652-6500