Healthcare Provider Details

I. General information

NPI: 1669306809
Provider Name (Legal Business Name): ALAN MATTHEW LANIER OD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/11/2026
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25200 LA PAZ RD STE 100
LAGUNA HILLS CA
92653-5134
US

IV. Provider business mailing address

145 CALAIS CT SE
GRAND RAPIDS MI
49546-1507
US

V. Phone/Fax

Practice location:
  • Phone: 949-489-2218
  • Fax:
Mailing address:
  • Phone: 616-560-7772
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number36314
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: