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General NPI Number Information
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NPI Number | 1477088979
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Entity Type | Individual
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Provider Name | THOMAS ADRIANO MCINNES LAZZARINI MD
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Gender | Male
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Dates
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Enumeration Date | 04/22/2017
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Last Update Date | 06/05/2025
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Provider Practice Location Address
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Address Line | 3965 FIFTH AVE STE 330
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City | SAN DIEGO
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State | CA
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Zip | 92103-3107
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Country | US
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Telephone | 858-451-1911
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Fax | 858-451-0566
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Provider Business Mailing Address
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Address Line | 12630 MONTE VISTA RD STE 104
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City | POWAY
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State | CA
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Zip | 92064-2526
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Country | US
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Telephone | 858-451-1911
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Fax | 858-451-0566
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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 | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | A191729
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | ME150161
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 207WX0107X
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Taxonomy Name | Retina Specialist (Ophthalmology) Physician
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License Number | A191729
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License Number State | CA
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