Provider Demographics
NPI:1720019631
Name:LESSER, STEVEN HARRY (MD)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:HARRY
Last Name:LESSER
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 1:8445 WILDCAT DR
Mailing Address - Street 2:
Mailing Address - City:EL CERRITO
Mailing Address - State:CA
Mailing Address - Zip Code:94530-2560
Mailing Address - Country:US
Mailing Address - Phone:504-416-9780
Mailing Address - Fax:
Practice Address - Street 1:8437 WILDCAT DR
Practice Address - Street 2:EMERGENCY MEDICINE
Practice Address - City:EL CERRITO
Practice Address - State:CA
Practice Address - Zip Code:94530-2560
Practice Address - Country:US
Practice Address - Phone:504-416-9780
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-06
Last Update Date:2011-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA016763207P00000X, 207R00000X
VA0101241741207PE0004X, 207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1720019631Medicaid
LA1334014Medicaid
VA1720019631Medicaid
VA015482V67Medicare PIN
P00477131Medicare PIN
B61859Medicare UPIN