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General NPI Number Information
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NPI Number | 1518026848
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Entity Type | Organization
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Legal Business Name | LAURIE BLANSCET, DO AN OSTEOPATHIC CORPORATION
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Dates
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Enumeration Date | 12/06/2006
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Last Update Date | 06/07/2019
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Provider Practice Location Address
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Address Line | 29995 TECHNOLOGY DR SUITE 201
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City | MURRIETA
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State | CA
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Zip | 92563-2632
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Country | US
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Telephone | 951-461-3021
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Fax | 951-461-8898
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Provider Business Mailing Address
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Address Line | 29995 TECHNOLOGY DR SUITE 201
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City | MURRIETA
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State | CA
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Zip | 92563-2632
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Country | US
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Telephone | 951-461-3021
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Fax | 951-461-3021
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. LAURIE BLANSCET
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Credential | D.O.
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Telephone | 951-461-3021
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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 | 20A7007
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License Number State | CA
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