Provider Demographics
NPI:1396265039
Name:LERNER, SHELDON (MD)
Entity type:Individual
Prefix:DR
First Name:SHELDON
Middle Name:
Last Name:LERNER
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 1:5780 CAMINITO NORTE
Mailing Address - Street 2:
Mailing Address - City:LA JOLLA
Mailing Address - State:CA
Mailing Address - Zip Code:92037-7227
Mailing Address - Country:US
Mailing Address - Phone:858-459-9143
Mailing Address - Fax:858-551-5423
Practice Address - Street 1:5780 CAMINITO NORTE
Practice Address - Street 2:
Practice Address - City:LA JOLLA
Practice Address - State:CA
Practice Address - Zip Code:92037-7227
Practice Address - Country:US
Practice Address - Phone:858-459-9143
Practice Address - Fax:858-551-5423
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-23
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC30695208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty