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NPI Code Detail

MEDICARE: LEE WAYNE ERLENDSON M.D.

MEDICARE: LEE WAYNE ERLENDSON 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
1207L00000XAnesthesiology PhysicianG50577CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
100G505770OTHERCABLUE SHIELD
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1962429886
Entity Type Code : Individual
Provider Name (Legal Business Name) : LEE WAYNE ERLENDSON M.D.
Provider Business Mailing Address
First Line : 39000 BOB HOPE DR
Second Line :
City : RANCHO MIRAGE
State : CA
Zip : 92270-3202
Country : US
Telephone Number : 760-773-3075
Fax Number : 760-773-3091
Provider Business Practice Location Address
First Line : 39000 BOB HOPE DR
Second Line :
City : RANCHO MIRAGE
State : CA
Zip : 92270-3202
Country : US
Telephone Number : 760-773-3075
Fax Number : 760-773-3091
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/16/2006
Last Update Date : 04/14/2026

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