Healthcare Provider Details

I. General information

NPI: 1407989148
Provider Name (Legal Business Name): ELIZABETH V. LENER, M.D., INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/13/2007
Last Update Date: 02/26/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 CORPORATE DR STE 240
LADERA RANCH CA
92694-2111
US

IV. Provider business mailing address

600 CORPORATE DR STE 240
LADERA RANCH CA
92694-2111
US

V. Phone/Fax

Practice location:
  • Phone: 949-364-8411
  • Fax: 949-364-8511
Mailing address:
  • Phone: 949-364-8411
  • Fax: 949-364-8511

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. ELIZABETH VERONIKA LENER
Title or Position: PRESIDENT
Credential: M.D.
Phone: 949-364-8411