Healthcare Provider Details

I. General information

NPI: 1083930259
Provider Name (Legal Business Name): LERNER MEDICAL DEVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/13/2010
Last Update Date: 04/13/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1545 SAWTELLE BLVD STE 36
LOS ANGELES CA
90025-3272
US

IV. Provider business mailing address

1545 SAWTELLE BLVD STE 36
LOS ANGELES CA
90025-3272
US

V. Phone/Fax

Practice location:
  • Phone: 310-914-0091
  • Fax: 310-914-0095
Mailing address:
  • Phone: 310-914-0091
  • Fax: 310-914-0095

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: ZAFIRIOS GOURGOULIATOS
Title or Position: CHIEF SCIENCE OFFICER
Credential: PH.D.
Phone: 310-914-0091