Provider Demographics
NPI:1558449033
Name:LAMPENFELD, MYLES E (MD)
Entity Type:Individual
Prefix:
First Name:MYLES
Middle Name:E
Last Name:LAMPENFELD
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 1:2317 LEIMERT BLVD
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94602-2017
Mailing Address - Country:US
Mailing Address - Phone:510-882-5530
Mailing Address - Fax:
Practice Address - Street 1:2500 W 12TH ST STE A
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16505-4500
Practice Address - Country:US
Practice Address - Phone:814-838-9000
Practice Address - Fax:814-838-0464
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2019-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG443882085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G443880Medicaid
CA00G443880Medicaid
A49629Medicare UPIN