Provider Demographics
NPI:1831209220
Name:LENSKY, MARINA GOLDOVSKY (MD)
Entity type:Individual
Prefix:DR
First Name:MARINA
Middle Name:GOLDOVSKY
Last Name:LENSKY
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 1:300 UCLA MEDICAL PLAZA
Mailing Address - Street 2:SUITE 2200
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90095-6968
Mailing Address - Country:US
Mailing Address - Phone:818-645-2003
Mailing Address - Fax:
Practice Address - Street 1:300 UCLA MEDICAL PLAZA
Practice Address - Street 2:SUITE 2200
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90095-6968
Practice Address - Country:US
Practice Address - Phone:818-645-2003
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2012-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA1048372084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1831209220Medicaid
CAFX014YMedicare PIN