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General NPI Number Information
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NPI Number | 1922567387
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Entity Type | Organization
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Legal Business Name | DAVID LAZAR M.D., A MEDICAL CORP
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Dates
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Enumeration Date | 03/15/2019
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Last Update Date | 08/30/2024
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Provider Practice Location Address
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Address Line | 12301 WILSHIRE BLVD # 420
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City | LOS ANGELES
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State | CA
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Zip | 90025-1007
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Country | US
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Telephone | 866-773-8462
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Fax | 818-659-7695
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Provider Business Mailing Address
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Address Line | 12301 WILSHIRE BLVD STE 420
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City | LOS ANGELES
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State | CA
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Zip | 90025-1007
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Country | US
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Telephone | 866-773-8462
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Fax | 818-659-7695
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Authorized Official
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Title or Position | OWNER
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Name | DAVID B. LAZAR
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Credential | MD
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Telephone | 866-773-8462
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207WX0107X
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Taxonomy Name | Retina Specialist (Ophthalmology) Physician
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License Number |
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License Number State |
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