=====================================================
General NPI Number Information
=====================================================
NPI Number | 1578735627
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | LAWRENCE J. MCCARTHY, MD, INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/28/2008
-----------------------------------------------------
Last Update Date | 03/28/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3927 WARING RD STE A
-----------------------------------------------------
City | OCEANSIDE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92056-4458
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 760-758-1525
-----------------------------------------------------
Fax | 760-758-1525
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3927 WARING RD STE A
-----------------------------------------------------
City | OCEANSIDE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92056-4458
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 760-758-1525
-----------------------------------------------------
Fax | 760-758-1525
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OFFICE MANAGER
-----------------------------------------------------
Name | MS. TINA J LAWLER
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 760-758-1525
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 174400000X
-----------------------------------------------------
Taxonomy Name | Specialist
-----------------------------------------------------
License Number | G35802
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------