Healthcare Provider Details

I. General information

NPI: 1558449033
Provider Name (Legal Business Name): MYLES E LAMPENFELD MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 11/22/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 W 12TH ST STE A
ERIE PA
16505-4500
US

IV. Provider business mailing address

2317 LEIMERT BLVD
OAKLAND CA
94602-2017
US

V. Phone/Fax

Practice location:
  • Phone: 814-838-9000
  • Fax: 814-838-0464
Mailing address:
  • Phone: 510-882-5530
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License NumberG44388
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: