Provider Demographics
NPI:1932614229
Name:LALEZARI SURGICAL
Entity Type:Organization
Organization Name:LALEZARI SURGICAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:SEPEHR
Authorized Official - Middle Name:
Authorized Official - Last Name:LALEZARI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:213-545-1656
Mailing Address - Street 1:606 S HILL ST STE 218
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90014-1756
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1245 WILSHIRE BLVD STE 907
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90017-4809
Practice Address - Country:US
Practice Address - Phone:213-545-1656
Practice Address - Fax:213-606-0586
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-07
Last Update Date:2020-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty