Healthcare Provider Details

I. General information

NPI: 1043370018
Provider Name (Legal Business Name): ARTHUR JULES LAZIK M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/11/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19150 BALLINGER ST
NORTHRIDGE CA
91324-1701
US

IV. Provider business mailing address

19150 BALLINGER ST
NORTHRIDGE CA
91324-1701
US

V. Phone/Fax

Practice location:
  • Phone: 818-993-0508
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License NumberG14374
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: