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General NPI Number Information
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NPI Number | 1275504524
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Entity Type | Individual
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Provider Name | BRIAN ALEXANDER LENSER MD
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Gender | Male
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Dates
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Enumeration Date | 01/26/2006
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Last Update Date | 10/15/2010
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Provider Practice Location Address
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Address Line | 3109 COFFEE RD STE C
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City | MODESTO
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State | CA
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Zip | 95355-1766
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Country | US
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Telephone | 209-572-8528
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Fax | 209-572-8530
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Provider Business Mailing Address
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Address Line | PO BOX 576644
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City | MODESTO
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State | CA
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Zip | 95357-6644
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Country | US
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Telephone | 209-572-8528
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Fax | 209-572-8530
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | G75079
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License Number State | CA
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