Provider Demographics
NPI:1811083389
Name:MARK LEMBERSKY D P M A PROFESSIONAL CORPORATION
Entity type:Organization
Organization Name:MARK LEMBERSKY D P M A PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:LEMBERSKY
Authorized Official - Suffix:
Authorized Official - Credentials:D P M
Authorized Official - Phone:818-566-6668
Mailing Address - Street 1:5225 WHITE OAK AVE #4
Mailing Address - Street 2:MARK LEMBERSKY DPM APC
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91316
Mailing Address - Country:US
Mailing Address - Phone:818-566-6668
Mailing Address - Fax:818-566-4386
Practice Address - Street 1:948 N FAIFAX AVE UNIT 201
Practice Address - Street 2:
Practice Address - City:WEST HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:90046-7261
Practice Address - Country:US
Practice Address - Phone:818-566-6668
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-04
Last Update Date:2022-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP1100XAmbulatory Health Care FacilitiesClinic/CenterPodiatric
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA000E40570Medicaid
CA000E40570Medicaid