Provider Demographics
NPI:1114920428
Name:LEMBERT, EDWARD A (MD)
Entity Type:Individual
Prefix:
First Name:EDWARD
Middle Name:A
Last Name:LEMBERT
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 1:7235 N 1ST ST
Mailing Address - Street 2:SUITE 103
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93720-2964
Mailing Address - Country:US
Mailing Address - Phone:559-432-2600
Mailing Address - Fax:559-432-8518
Practice Address - Street 1:7235 N 1ST ST
Practice Address - Street 2:SUITE 103
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93720-2964
Practice Address - Country:US
Practice Address - Phone:559-432-2600
Practice Address - Fax:559-432-8518
Is Sole Proprietor?:Yes
Enumeration Date:2005-05-31
Last Update Date:2009-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC35648207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1063558492OtherGROUP NPI
CAZZZ04265ZOtherMEDICARE GROUP ID
CA00C356480Medicaid
CAA26039Medicare UPIN
CA00C356480Medicaid