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Organization
LIPOV MEDICAL PC
Active
Organization
LIPOV MEDICAL PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL GERSHENZON (CHIEF FINANCIAL OFFICER)
(937) 838-0568
Entity
Organization
Contact information
Practice address
15785 LAGUNA CANYON RD STE 125, IRVINE, CA 92618-3140
(937) 838-0568
Mailing address
15785 LAGUNA CANYON RD STE 125, IRVINE, CA 92618-3140
(937) 838-0568
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
207LP2900X
Pain Medicine (Anesthesiology) Physician
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
364SP0808X
Psychiatric/Mental Health Clinical Nurse Specialist
—
—
Other
Enumeration date
09/26/2023
Last updated
09/26/2023
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