Provider Demographics
NPI:1285699595
Name:LERNER, A. DAVID (MD)
Entity type:Individual
Prefix:
First Name:A.
Middle Name:DAVID
Last Name:LERNER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:ABRAHAM
Other - Middle Name:DAVID
Other - Last Name:LERNER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:5821 JAMESON CT
Mailing Address - Street 2:
Mailing Address - City:CARMICHAEL
Mailing Address - State:CA
Mailing Address - Zip Code:95608-0820
Mailing Address - Country:US
Mailing Address - Phone:916-486-0411
Mailing Address - Fax:916-486-0525
Practice Address - Street 1:5821 JAMESON CT
Practice Address - Street 2:
Practice Address - City:CARMICHAEL
Practice Address - State:CA
Practice Address - Zip Code:95608-0820
Practice Address - Country:US
Practice Address - Phone:916-486-0411
Practice Address - Fax:916-486-0525
Is Sole Proprietor?:No
Enumeration Date:2006-04-19
Last Update Date:2015-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA39649207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAYYY49032YMedicaid
YYY49032YMedicare ID - Type Unspecified
CAYYY49032YMedicaid