Healthcare Provider Details

I. General information

NPI: 1851314413
Provider Name (Legal Business Name): LEONARD HILLEL LAZARUS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: LEONARD HILLEL LAZARUS M.D.

II. Dates (important events)

Enumeration Date: 07/25/2006
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7450 OLIVETAS AVE
LA JOLLA CA
92037-4900
US

IV. Provider business mailing address

7450 OLIVETAS AVE
LA JOLLA CA
92037-4924
US

V. Phone/Fax

Practice location:
  • Phone: 858-450-5286
  • Fax: 858-454-4579
Mailing address:
  • Phone: 858-450-5286
  • Fax: 858-454-4579

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA40022
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: