Provider Demographics
NPI:1538130380
Name:LEMOR, MARCOS (MD)
Entity Type:Individual
Prefix:DR
First Name:MARCOS
Middle Name:
Last Name:LEMOR
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 1:4036 WHITTIER BLVD
Mailing Address - Street 2:SUITE 202
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90023-2560
Mailing Address - Country:US
Mailing Address - Phone:323-262-3333
Mailing Address - Fax:323-262-3528
Practice Address - Street 1:4036 WHITTIER BLVD
Practice Address - Street 2:SUITE 202
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90023-2560
Practice Address - Country:US
Practice Address - Phone:323-262-3333
Practice Address - Fax:323-262-3528
Is Sole Proprietor?:No
Enumeration Date:2006-01-30
Last Update Date:2008-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA45400207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A454002Medicaid
CA00A454002Medicaid
CAA45400AMedicare ID - Type Unspecified