Healthcare Provider Details

I. General information

NPI: 1053406850
Provider Name (Legal Business Name): SAMUEL LEHMAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/04/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6235 N FRESNO ST SUITE # 103
FRESNO CA
93710-5269
US

IV. Provider business mailing address

6235 N FRESNO ST SUITE # 103
FRESNO CA
93710-5269
US

V. Phone/Fax

Practice location:
  • Phone: 559-449-4350
  • Fax: 559-449-4362
Mailing address:
  • Phone: 559-449-4350
  • Fax: 559-449-4362

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0203X
TaxonomyPediatric Critical Care Medicine Physician
License NumberA60446
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: