Provider Demographics
NPI:1144615659
Name:LENHART-PENDERGRASS, PATRICIA MARIE (MD/PHD)
Entity Type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:MARIE
Last Name:LENHART-PENDERGRASS
Suffix:
Gender:F
Credentials:MD/PHD
Other - Prefix:
Other - First Name:PATRICIA
Other - Middle Name:MARIE
Other - Last Name:LENHART
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3020 CHILDRENS WAY # MC5003
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92123-4223
Mailing Address - Country:US
Mailing Address - Phone:858-309-6300
Mailing Address - Fax:
Practice Address - Street 1:3030 CHILDRENS WAY
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92123-4232
Practice Address - Country:US
Practice Address - Phone:858-966-5846
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-04-01
Last Update Date:2022-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODR.00603272080P0214X
CAA1793312080P0214X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0214XAllopathic & Osteopathic PhysiciansPediatricsPediatric Pulmonology