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General NPI Number Information
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NPI Number | 1447305099
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Entity Type | Organization
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Legal Business Name | GARY JOHN LAWSON MD A MEDICAL CORPORATION
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Dates
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Enumeration Date | 01/24/2007
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 17447 CHATSWORTH ST
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City | GRANADA HILLS
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State | CA
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Zip | 91344-5718
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Country | US
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Telephone | 818-360-1858
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Fax | 818-360-4979
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Provider Business Mailing Address
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Address Line | 17447 CHATSWORTH ST
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City | GRANADA HILLS
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State | CA
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Zip | 91344-5718
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Country | US
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Telephone | 818-360-1858
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Fax | 818-360-4979
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Authorized Official
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Title or Position | SELF
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Name | DR. GARY JOHN LAWSON
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Credential | MD
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Telephone | 818-360-1858
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | C27864
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License Number State | CA
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