Healthcare Provider Details

I. General information

NPI: 1194934109
Provider Name (Legal Business Name): LAURA LUCILLE HOWARD M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/22/2007
Last Update Date: 01/03/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1031 W CHAPMAN AVE STE 204
ORANGE CA
92868-2872
US

IV. Provider business mailing address

1031 W CHAPMAN AVE STE 204
ORANGE CA
92868-2872
US

V. Phone/Fax

Practice location:
  • Phone: 714-997-7000
  • Fax: 714-538-1142
Mailing address:
  • Phone: 714-997-7000
  • Fax: 714-538-1142

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number77434
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberA110196
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: