Provider Demographics
NPI:1083930259
Name:LERNER MEDICAL DEVICES, INC.
Entity Type:Organization
Organization Name:LERNER MEDICAL DEVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF SCIENCE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:ZAFIRIOS
Authorized Official - Middle Name:
Authorized Official - Last Name:GOURGOULIATOS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:310-914-0091
Mailing Address - Street 1:1545 SAWTELLE BLVD STE 36
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90025-3272
Mailing Address - Country:US
Mailing Address - Phone:310-914-0091
Mailing Address - Fax:310-914-0095
Practice Address - Street 1:1545 SAWTELLE BLVD STE 36
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90025-3272
Practice Address - Country:US
Practice Address - Phone:310-914-0091
Practice Address - Fax:310-914-0095
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-13
Last Update Date:2010-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies