Organization
SCOTT C LEDERHAUS MD & LEW B DISNEY MD PRT LEDERHAUS SCOTT C GEN PTR
Active
Other names
Inland Neurosurgery Institute, Lederhaus Disney and Rodriguez
Organization subpart
No
Provider details
NPI number
Authorized official
ANNA M PEREZ (OFFICE MANAGER)
(909) 450-0369
Entity
Organization
Contact information
Practice address
255 E BONITA AVE, BLDG #9, POMONA, CA 91767-1923
(909) 450-0369
(909) 450-0366
Mailing address
255 E BONITA AVE, BLDG #9, POMONA, CA 91767-1923
(909) 450-0369
(909) 450-0366
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A986190
—
CA
01
—
CA123795
MEDICARE NORTH CUTLER
—
01
—
CB216289
MEDICARE SOUTH CUTLER
CA
05
—
GR0099730
—
CA
Enumeration date
01/18/2007
Last updated
08/12/2021
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