Provider Demographics
NPI:1740236967
Name:LUNSFORD, LEIF E (MD)
Entity Type:Individual
Prefix:
First Name:LEIF
Middle Name:E
Last Name:LUNSFORD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:239 S LA CIENEGA BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90211-3328
Mailing Address - Country:US
Mailing Address - Phone:310-360-0960
Mailing Address - Fax:310-360-0972
Practice Address - Street 1:239 S LA CIENEGA BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90211-3328
Practice Address - Country:US
Practice Address - Phone:310-360-0960
Practice Address - Fax:310-360-0972
Is Sole Proprietor?:No
Enumeration Date:2006-05-26
Last Update Date:2014-06-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA87825207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAI60550Medicare UPIN