MEDICARE: DR. NORMAN LEPOR M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	C41453	CA

General Provider Information

NPI Number	:	1013979673
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NORMAN LEPOR M.D.

Provider Business Mailing Address
First Line	:	99 N LA CIENEGA BLVD
Second Line	:	#103
City	:	BEVERLY HILLS
State	:	CA
Zip	:	90211-2222
Country	:	US
Telephone Number	:	310-623-1146
Fax Number	:	310-623-1142

Provider Business Practice Location Address
First Line	:	99 N LA CIENEGA BLVD
Second Line	:	#203
City	:	BEVERLY HILLS
State	:	CA
Zip	:	90211-2222
Country	:	US
Telephone Number	:	310-289-9955
Fax Number	:	310-623-1142

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/06/2006
Last Update Date	:	10/01/2012

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