Provider Demographics
NPI:1881708220
Name:LESIN BALFOUR AND ZIV A PROF MED CORP
Entity type:Organization
Organization Name:LESIN BALFOUR AND ZIV A PROF MED CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:W
Authorized Official - Last Name:BALFOUR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:818-902-2800
Mailing Address - Street 1:4849 VAN NUYS BLVD STE 217
Mailing Address - Street 2:
Mailing Address - City:SHERMAN OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91403-2128
Mailing Address - Country:US
Mailing Address - Phone:818-902-2800
Mailing Address - Fax:818-902-2810
Practice Address - Street 1:4849 VAN NUYS BLVD STE 217
Practice Address - Street 2:
Practice Address - City:SHERMAN OAKS
Practice Address - State:CA
Practice Address - Zip Code:91403-2128
Practice Address - Country:US
Practice Address - Phone:818-902-2800
Practice Address - Fax:818-782-8979
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-19
Last Update Date:2024-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand SurgeryGroup - Multi-Specialty
No225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHandGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW3130Medicare PIN
0881790001Medicare NSC