Healthcare Provider Details

I. General information

NPI: 1407114341
Provider Name (Legal Business Name): LANA YAROSLAVA FLIPPO M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/29/2012
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20800 SHERMAN WAY
WINNETKA CA
91306-2707
US

IV. Provider business mailing address

20800 SHERMAN WAY
WINNETKA CA
91306-2707
US

V. Phone/Fax

Practice location:
  • Phone: 818-883-2273
  • Fax: 818-347-3016
Mailing address:
  • Phone: 818-883-2273
  • Fax: 818-347-3016

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA138358
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: