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General NPI Number Information
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NPI Number | 1841681467
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Entity Type | Organization
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Legal Business Name | LAUREN LAYSON
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Dates
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Enumeration Date | 02/18/2015
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Last Update Date | 02/18/2015
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Provider Practice Location Address
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Address Line | 4049 VIA MARISOL
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City | LOS ANGELES
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State | CA
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Zip | 90042-5055
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Country | US
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Telephone | 714-906-2860
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Fax |
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Provider Business Mailing Address
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Address Line | 4049 VIA MARISOL
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City | LOS ANGELES
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State | CA
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Zip | 90042-5055
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN ASSISTANT
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Name | MS. LAUREN ANNE ZABALA LAYSON
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Credential |
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Telephone | 714-906-2860
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 51851
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License Number State | CA
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