Healthcare Provider Details

I. General information

NPI: 1194758409
Provider Name (Legal Business Name): LIONEL A CONE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/09/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7515 VAN NUYS BLVD SUITE # 541 MID VALLEY COMPREHENSIVE HEALTH CENTER
VAN NUYS CA
91405-9149
US

IV. Provider business mailing address

7515 VAN NUYS BLVD SUITE # 541 MID VALLEY COMPREHENSIVE HEALTH CENTER
VAN NUYS CA
91405-9149
US

V. Phone/Fax

Practice location:
  • Phone: 818-947-4026
  • Fax: 818-989-8850
Mailing address:
  • Phone: 818-947-4026
  • Fax: 818-989-8850

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number635053
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: