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General NPI Number Information
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NPI Number | 1912930512
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Entity Type | Organization
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Legal Business Name | LAWRENCE A. MORA MD INC
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Dates
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Enumeration Date | 07/08/2006
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Last Update Date | 02/24/2021
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Provider Practice Location Address
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Address Line | 5901 W OLYMPIC BLVD STE 404
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City | LOS ANGELES
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State | CA
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Zip | 90036-4669
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Country | US
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Telephone | 323-456-0185
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Fax | 323-443-1744
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Provider Business Mailing Address
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Address Line | 5901 W OLYMPIC BLVD STE 404
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City | LOS ANGELES
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State | CA
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Zip | 90036-4669
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Country | US
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Telephone | 323-456-0185
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Fax | 323-443-1744
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Authorized Official
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Title or Position | PRESIDENT
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Name | LAWRENCE A MORA
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Credential | MD
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Telephone | 323-456-0185
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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 |
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License Number State |
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