Provider Demographics
NPI:1871562496
Name:LENABURG, WILLIAM R (MD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:R
Last Name:LENABURG
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:16661 VENTURA BLVD
Mailing Address - Street 2:SUITE 108
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91436-1914
Mailing Address - Country:US
Mailing Address - Phone:818-808-2828
Mailing Address - Fax:818-788-0386
Practice Address - Street 1:16661 VENTURA BLVD
Practice Address - Street 2:SUITE 108
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91436-1914
Practice Address - Country:US
Practice Address - Phone:818-808-2828
Practice Address - Fax:818-788-0386
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-16
Last Update Date:2015-12-29
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Provider Licenses
StateLicense IDTaxonomies
CAG51103207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
E 51137Medicare UPIN