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NPI Code Detail

MEDICARE: MR. MICHAEL LENARDO PAYNE JR.

MEDICARE:  MR. MICHAEL LENARDO PAYNE JR.
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
1207PE0004XEmergency Medical Services (Emergency Medicine) PhysicianE151623CA

General Provider Information

NPI Number : 1790611192
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. MICHAEL LENARDO PAYNE JR.
Provider Business Mailing Address
First Line : 4316 LOS FELIZ BLVD # 1
Second Line :
City : LOS ANGELES
State : CA
Zip : 90027-2215
Country : US
Telephone Number : 805-210-4001
Fax Number :
Provider Business Practice Location Address
First Line : 4316 LOS FELIZ BLVD # 1
Second Line :
City : LOS ANGELES
State : CA
Zip : 90027-2215
Country : US
Telephone Number : 805-210-4001
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/23/2026
Last Update Date : 06/23/2026

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Directions to “ MR. MICHAEL LENARDO PAYNE JR. ” Practice Location

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