Provider Demographics
NPI:1154377315
Name:LAZAR, ALEX A (MD)
Entity type:Individual
Prefix:DR
First Name:ALEX
Middle Name:A
Last Name:LAZAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:ARASH
Other - Middle Name:A
Other - Last Name:LALEZARIAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:16055 VENTURA BLVD STE 601
Mailing Address - Street 2:
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91436-2618
Mailing Address - Country:US
Mailing Address - Phone:818-783-9922
Mailing Address - Fax:818-783-3832
Practice Address - Street 1:16055 VENTURA BLVD STE 601
Practice Address - Street 2:
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91436-2618
Practice Address - Country:US
Practice Address - Phone:818-783-9922
Practice Address - Fax:818-783-9920
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-26
Last Update Date:2023-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA678222084P0804X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry