Healthcare Provider Details

I. General information

NPI: 1457274201
Provider Name (Legal Business Name): DAVID ERIC LASRY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/30/2026
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 PASTEUR DR # L134
STANFORD CA
94305-2200
US

IV. Provider business mailing address

300 PASTEUR DR # L134
STANFORD CA
94305-2200
US

V. Phone/Fax

Practice location:
  • Phone: 650-723-4000
  • Fax:
Mailing address:
  • Phone: 650-470-9166
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License NumberA210966
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: