Provider Demographics
NPI:1861875601
Name:LENARTOWICZ, MAGDA (MD)
Entity type:Individual
Prefix:DR
First Name:MAGDA
Middle Name:
Last Name:LENARTOWICZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MAGDALENA
Other - Middle Name:
Other - Last Name:LENARTOWICZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2629 FOOTHILL BLVD # 246
Mailing Address - Street 2:
Mailing Address - City:LA CRESCENTA
Mailing Address - State:CA
Mailing Address - Zip Code:91214-3511
Mailing Address - Country:US
Mailing Address - Phone:818-747-5785
Mailing Address - Fax:
Practice Address - Street 1:10945 LE CONTE AVE STE 2339
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90095-1687
Practice Address - Country:US
Practice Address - Phone:310-825-5421
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-29
Last Update Date:2021-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA137356207R00000X, 207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine