Provider Demographics
NPI:1669650529
Name:MARK SCHLESINGER, M.D., A PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:MARK SCHLESINGER, M.D., A PROFESSIONAL CORPORATION
Other - Org Name:SCHLESINGER PAIN CENTERS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:P
Authorized Official - Last Name:SCHLESINGER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:818-845-8100
Mailing Address - Street 1:2031 W ALAMEDA AVE
Mailing Address - Street 2:SUITE 330
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91506-2958
Mailing Address - Country:US
Mailing Address - Phone:818-845-8100
Mailing Address - Fax:818-845-8120
Practice Address - Street 1:2031 W ALAMEDA AVE
Practice Address - Street 2:SUITE 330
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91506-2958
Practice Address - Country:US
Practice Address - Phone:818-845-8100
Practice Address - Fax:818-845-8120
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-03
Last Update Date:2011-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG80039207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G500390OtherBLUE SHIELD
CAW21827Medicare PIN
CA00G500390OtherBLUE SHIELD
A51547Medicare UPIN