MEDICARE: MISHA LANZAT, D.P.M., INC.

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	213E00000X	Podiatrist	E3726	CA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	480032782	OTHER	CA	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1114973591
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MISHA LANZAT, D.P.M., INC.

Provider Business Mailing Address
First Line	:	3743 WHITTIER BLVD
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90023-1703
Country	:	US
Telephone Number	:	323-268-2711
Fax Number	:	323-268-9260

Provider Business Practice Location Address
First Line	:	3743 WHITTIER BLVD
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90023-1703
Country	:	US
Telephone Number	:	323-268-2711
Fax Number	:	323-268-9260

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. MISHA LANZAT
Credential	:	D.P.M.
Telephone Number	:	323-268-2711

Provider Enumeration Date	:	05/26/2006
Last Update Date	:	05/01/2008

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Directions to “MISHA LANZAT, D.P.M., INC. ” Practice Location

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