Healthcare Provider Details

I. General information

NPI: 1265917595
Provider Name (Legal Business Name): LANNY RUDNER, M.D., P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/02/2018
Last Update Date: 03/16/2021
Certification Date: 03/16/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

99 N LA CIENEGA BLVD STE 304
BEVERLY HILLS CA
90211-2286
US

IV. Provider business mailing address

200 S BARRINGTON AVE UNIT 49857
LOS ANGELES CA
90049-7836
US

V. Phone/Fax

Practice location:
  • Phone: 310-362-3088
  • Fax: 310-388-3184
Mailing address:
  • Phone: 310-362-3088
  • Fax: 310-388-3184

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207XX0004X
TaxonomyOrthopaedic Foot and Ankle Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. LANNY RUDNER
Title or Position: PRESIDENT
Credential: MD
Phone: 310-362-3088