Individual
LEONID EDUARD LERNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D., PH.D.
Contact information
Practice address
3 CORPORATE PLAZA DR, SUITE 150, NEWPORT BEACH, CA 92660-7905
(949) 721-1701
(949) 612-1910
Mailing address
1441 AVOCADO AVE, STE 204, NEWPORT BEACH, CA 92660-7703
(949) 721-1701
(949) 612-1910
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
A54458
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CB770X
MEDICARE PTAN
CA
01
—
CB770Y
MEDICARE PTAN
CA
Enumeration date
05/18/2006
Last updated
05/17/2016
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