Healthcare Provider Details

I. General information

NPI: 1104935873
Provider Name (Legal Business Name): CLARA PALMA LAUER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CLARA ESTHER PALMA MD

II. Dates (important events)

Enumeration Date: 08/29/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7600 N 15TH ST STE 130
PHOENIX AZ
85020-4347
US

IV. Provider business mailing address

7600 N 15TH ST STE 130
PHOENIX AZ
85020-4347
US

V. Phone/Fax

Practice location:
  • Phone: 602-861-1611
  • Fax: 602-371-8929
Mailing address:
  • Phone: 602-861-1611
  • Fax: 602-371-8929

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number28465
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: