Healthcare Provider Details

I. General information

NPI: 1962509869
Provider Name (Legal Business Name): PIERRE DANIEL LAMOTHE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 08/21/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 UPPER RAGSDALE DR SUITE B-210
MONTEREY CA
93940-5736
US

IV. Provider business mailing address

2 UPPER RAGSDALE DR SUITE B-210
MONTEREY CA
93940-5736
US

V. Phone/Fax

Practice location:
  • Phone: 831-333-0999
  • Fax: 831-333-0909
Mailing address:
  • Phone: 831-333-0999
  • Fax: 831-333-0909

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberG56770
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: