Healthcare Provider Details

I. General information

NPI: 1881708220
Provider Name (Legal Business Name): LESIN BALFOUR AND ZIV A PROF MED CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/19/2006
Last Update Date: 10/22/2024
Certification Date: 10/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4849 VAN NUYS BLVD STE 217
SHERMAN OAKS CA
91403-2128
US

IV. Provider business mailing address

4849 VAN NUYS BLVD STE 217
SHERMAN OAKS CA
91403-2128
US

V. Phone/Fax

Practice location:
  • Phone: 818-902-2800
  • Fax: 818-782-8979
Mailing address:
  • Phone: 818-902-2800
  • Fax: 818-902-2810

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XS0106X
TaxonomyOrthopaedic Hand Surgery Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225XH1200X
TaxonomyHand Occupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: DR. GEORGE W BALFOUR
Title or Position: PRESIDENT
Credential: M.D.
Phone: 818-902-2800