Basic Information
Provider Information
NPI: 1760707210
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: LEHNERT SCHUCHARDT
FirstName: ELEANOR
MiddleName: LEA
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: LEHNERT
OtherFirstName: ELEANOR
OtherMiddleName: LEA
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType: 1
Mailing Information
Address1: 3020 CHILDRENS WAY # MC5003
Address2:  
City: SAN DIEGO
State: CA
PostalCode: 921234223
CountryCode: US
TelephoneNumber: 8583096300
FaxNumber:  
Practice Location
Address1: 3020 CHILDRENS WAY
Address2:  
City: SAN DIEGO
State: CA
PostalCode: 92123
CountryCode: US
TelephoneNumber: 8589665855
FaxNumber:  
Other Information
ProviderEnumerationDate: 03/27/2010
LastUpdateDate: 07/27/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2080P0202XDR0052573CON Allopathic & Osteopathic PhysiciansPediatricsPediatric Cardiology
2080P0202XA156946CAY Allopathic & Osteopathic PhysiciansPediatricsPediatric Cardiology

No ID Information.


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