Provider Demographics
NPI:1114964228
Name:LERNER, CARLOS F (MD)
Entity Type:Individual
Prefix:
First Name:CARLOS
Middle Name:F
Last Name:LERNER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:GENERAL PEDIATRICS 12 466 MDCC
Mailing Address - Street 2:10833 LE CONTE AVE
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90095-0001
Mailing Address - Country:US
Mailing Address - Phone:310-794-2163
Mailing Address - Fax:310-206-4855
Practice Address - Street 1:GENERAL PEDIATRICS 12 466 MDCC
Practice Address - Street 2:10833 LE CONTE AVE
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90095-0001
Practice Address - Country:US
Practice Address - Phone:310-794-2163
Practice Address - Fax:310-206-4855
Is Sole Proprietor?:No
Enumeration Date:2006-05-31
Last Update Date:2012-08-29
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Provider Licenses
StateLicense IDTaxonomies
CAA98508208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWA98508AMedicare PIN