Provider Demographics
NPI:1093971293
Name:RUDNER, LANNY (MD)
Entity Type:Individual
Prefix:DR
First Name:LANNY
Middle Name:
Last Name:RUDNER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 S BARRINGTON AVE UNIT 49857
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90049-7836
Mailing Address - Country:US
Mailing Address - Phone:310-362-3088
Mailing Address - Fax:310-388-3184
Practice Address - Street 1:99 N LA CIENEGA BLVD STE 304
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90211-2286
Practice Address - Country:US
Practice Address - Phone:310-362-3088
Practice Address - Fax:310-388-3184
Is Sole Proprietor?:No
Enumeration Date:2008-08-06
Last Update Date:2021-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA118170207X00000X, 207XX0004X, 207XX0004X
NE27503207X00000X, 207XX0004X
MEMD21554207XX0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0004XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryFoot and Ankle Surgery
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery