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General NPI Number Information
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NPI Number | 1003150434
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Entity Type | Individual
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Provider Name | DEREK LAWRENCE N.D.
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Gender | Male
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Dates
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Enumeration Date | 11/26/2012
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Last Update Date | 03/26/2021
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Provider Practice Location Address
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Address Line | 620 GRAND AVE STE C
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City | CARLSBAD
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State | CA
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Zip | 92008-2363
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Country | US
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Telephone | 760-306-4842
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Fax | 760-306-4844
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Provider Business Mailing Address
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Address Line | 620 GRAND AVE STE C
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City | CARLSBAD
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State | CA
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Zip | 92008-2363
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Country | US
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Telephone | 760-306-4842
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Fax | 760-306-4844
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 175F00000X
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Taxonomy Name | Naturopath
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License Number | ND-560
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License Number State | CA
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