Healthcare Provider Details

I. General information

NPI: 1487841409
Provider Name (Legal Business Name): LAWRENCE M. HIGHMAN, M.D., INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/03/2007
Last Update Date: 10/03/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

155 E WEBSTER ST
COLUSA CA
95932-2949
US

IV. Provider business mailing address

155 E WEBSTER ST
COLUSA CA
95932-2949
US

V. Phone/Fax

Practice location:
  • Phone: 530-458-7728
  • Fax: 530-458-7013
Mailing address:
  • Phone: 530-458-7728
  • Fax: 530-458-7013

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberG40201
License Number StateCA

VIII. Authorized Official

Name: DR. LAWRENCE MARSHALL HIGHMAN
Title or Position: OWNER
Credential: M.D.
Phone: 530-458-7728