MEDICARE: DR. HAROLD ALLEN LANCER M.D., F.A.A.D

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	G49309	CA

General Provider Information

NPI Number	:	1518131747
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HAROLD ALLEN LANCER M.D., F.A.A.D

Provider Business Mailing Address
First Line	:	9735 WILSHIRE BLVD ., PH
Second Line	:
City	:	BEVERLY HILLS
State	:	CA
Zip	:	90212
Country	:	US
Telephone Number	:	310-278-8444
Fax Number	:	310-278-7626

Provider Business Practice Location Address
First Line	:	9735 WILSHIRE BLVD PH
Second Line	:
City	:	BEVERLY HILLS
State	:	CA
Zip	:	90212-2104
Country	:	US
Telephone Number	:	310-278-8444
Fax Number	:	310-278-7626

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/18/2008
Last Update Date	:	04/18/2008

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