Healthcare Provider Details

I. General information

NPI: 1134139777
Provider Name (Legal Business Name): LAWRENCE ALAN TEPLIN DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/08/2006
Last Update Date: 04/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

909 SAN RAMON VALLEY BLVD STE. 118
DANVILLE CA
94526-4038
US

IV. Provider business mailing address

2637 SHADELANDS DR
WALNUT CREEK CA
94598-2512
US

V. Phone/Fax

Practice location:
  • Phone: 925-362-1080
  • Fax: 925-362-1083
Mailing address:
  • Phone: 925-948-8143
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License NumberE1397
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: