MEDICARE: ELSA LAPUZ LERRO 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	207R00000X	Internal Medicine Physician	A70040	CA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	00A700400	OTHER		MEDICARE ID

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	04729612	OTHER		ECGMG NUMBER

General Provider Information

NPI Number	:	1366496770
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELSA LAPUZ LERRO M.D.

Provider Business Mailing Address
First Line	:	7575 N CEDAR AVE STE 101
Second Line	:
City	:	FRESNO
State	:	CA
Zip	:	93720-2693
Country	:	US
Telephone Number	:	559-549-9990
Fax Number	:	559-389-0796

Provider Business Practice Location Address
First Line	:	7575 N CEDAR AVE STE 101
Second Line	:
City	:	FRESNO
State	:	CA
Zip	:	93720-2693
Country	:	US
Telephone Number	:	559-549-9990
Fax Number	:	559-389-0796

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

Provider Enumeration Date	:	05/20/2006
Last Update Date	:	06/06/2023

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Directions to “ ELSA LAPUZ LERRO M.D.” Practice Location

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