Provider Demographics
NPI:1578781134
Name:LESER, ERIC W (OD)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:W
Last Name:LESER
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23161 VENTURA BLVD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91364-1105
Mailing Address - Country:US
Mailing Address - Phone:818-591-8860
Mailing Address - Fax:
Practice Address - Street 1:23161 VENTURA BLVD
Practice Address - Street 2:SUITE 201
Practice Address - City:WOODLAND HILLS
Practice Address - State:CA
Practice Address - Zip Code:91364-1105
Practice Address - Country:US
Practice Address - Phone:818-591-8860
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-20
Last Update Date:2011-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOP9289T152W00000X, 152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAOP9289Medicare ID - Type Unspecified
CAFA707ZMedicare PIN
CAU44907Medicare UPIN