Healthcare Provider Details

I. General information

NPI: 1104142025
Provider Name (Legal Business Name): LAURA ARMSTRONG PACE M.D., PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/16/2010
Last Update Date: 02/25/2026
Certification Date: 02/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1672 17TH ST
OAKLAND CA
94607-1644
US

IV. Provider business mailing address

1672 17TH ST
OAKLAND CA
94607-1644
US

V. Phone/Fax

Practice location:
  • Phone: 801-688-8636
  • Fax: 801-662-0468
Mailing address:
  • Phone: 801-688-8636
  • Fax: 801-662-0468

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QG0250X
TaxonomyGenetics Clinic/Center
License NumberA126140
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA126140
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberA126140
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: