Provider Demographics
NPI:1386716611
Name:YERZLEY, DAVID LESSING (MD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:LESSING
Last Name:YERZLEY
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 1:1624 W OLIVE AVE
Mailing Address - Street 2:SUITE F
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91506-2459
Mailing Address - Country:US
Mailing Address - Phone:818-843-2835
Mailing Address - Fax:818-843-3310
Practice Address - Street 1:1624 W OLIVE AVE
Practice Address - Street 2:SUITE F
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91506-2459
Practice Address - Country:US
Practice Address - Phone:818-843-2835
Practice Address - Fax:818-843-3310
Is Sole Proprietor?:No
Enumeration Date:2006-11-14
Last Update Date:2010-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG42373174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWG42373DMedicare PIN
CAA48930Medicare UPIN