Provider Demographics
NPI:1730159922
Name:LAPIDUS, YELENA S (MD)
Entity type:Individual
Prefix:DR
First Name:YELENA
Middle Name:S
Last Name:LAPIDUS
Suffix:
Gender:F
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:PO BOX 490
Mailing Address - Street 2:
Mailing Address - City:AVILA BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:93424-0490
Mailing Address - Country:US
Mailing Address - Phone:805-540-3071
Mailing Address - Fax:805-540-3072
Practice Address - Street 1:6685 BAY LAUREL PLACE
Practice Address - Street 2:
Practice Address - City:AVILA BEACH
Practice Address - State:CA
Practice Address - Zip Code:93424
Practice Address - Country:US
Practice Address - Phone:805-439-4825
Practice Address - Fax:805-540-3072
Is Sole Proprietor?:No
Enumeration Date:2006-01-23
Last Update Date:2021-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA88176207Q00000X, 207PE0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207PE0005XAllopathic & Osteopathic PhysiciansEmergency MedicineUndersea and Hyperbaric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A881760OtherBLUE SHIELD PIN
CA7560775OtherAETNA PIN
CA7560775OtherAETNA PIN
CA7560775OtherAETNA PIN
I34646Medicare UPIN
WA88176AMedicare PIN