Healthcare Provider Details

I. General information

NPI: 1154377315
Provider Name (Legal Business Name): ALEX A LAZAR M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: ARASH A LALEZARIAN M.D.

II. Dates (important events)

Enumeration Date: 05/26/2006
Last Update Date: 05/26/2023
Certification Date: 05/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16055 VENTURA BLVD STE 601
ENCINO CA
91436-2618
US

IV. Provider business mailing address

16055 VENTURA BLVD STE 601
ENCINO CA
91436-2618
US

V. Phone/Fax

Practice location:
  • Phone: 818-783-9922
  • Fax: 818-783-9920
Mailing address:
  • Phone: 818-783-9922
  • Fax: 818-783-3832

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License NumberA67822
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberA67822
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: