NPIMap

Elizabeth V. Lener, M.D., Inc.

Organization Active NPI Dermatology Physician · Ladera Ranch, CA

NPI 1407989148 · NPPES record last updated Feb 26, 2015

Key facts

NPI
1407989148
Entity type
Organization (NPI type 2)
Primary specialty
Dermatology Physician 207N00000X
Legal business name
ELIZABETH V. LENER, M.D., INC.
Practice address
600 Corporate Dr Ste 240
Ladera Ranch, CA 92694-2111
Phone
(949) 364-8411
Fax
(949) 364-8511
NPI assigned
Mar 13, 2007
Organization subpart
No

Authorized official

Name
Dr. Elizabeth Veronika Lener, M.D.
Title
President
Phone
(949) 364-8411

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D1036647Dermatology Center at Ladera Inc
600 Corporate Dr, Ste 240, Ladera Ranch, CA 92694		ComplianceOct 19, 2027

Medicare participation

Medicare fee-for-service enrollment
Enrolled in CA

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20041202000500 CA Part B Supplier - Clinic/Group Practice 7618933516 Receives reassigned benefits from 4 practitioners
Practice locations: Ladera Ranch, CA

National Provider Directory

Locations

600 Corporate Dr
Ste 240
Ladera Ranch, CA 92694
Phone (949) 364-8411

600 Corporate Dr
Ste 230
Ladera Ranch, CA 92694
Phone (949) 364-8411

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD
    Plans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician
Group: 193400000X SINGLE SPECIALTY GROUP		 207N00000X Yes

Addresses

Primary practice location

600 Corporate Dr Ste 240
Ladera Ranch, CA 92694-2111

Mailing address

600 Corporate Dr Ste 240
Ladera Ranch, CA 92694-2111
Phone (949) 364-8411

Other names

  • The Dermatology Center at Ladera Doing business as

Other providers in Ladera Ranch, CA

All providers in Ladera Ranch, CA · Dermatology Physician in California

Sources for this page

Verify at the official NPI Registry.