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NPI Code Detail

MEDICARE: DR. MAURICIO DE LA LAMA MD

MEDICARE: DR. MAURICIO DE LA LAMA MD
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
12085R0202XDiagnostic Radiology PhysicianA121020CA

General Provider Information

NPI Number : 1669778056
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MAURICIO DE LA LAMA MD
Provider Business Mailing Address
First Line : 400 E 71ST ST
Second Line : 4A
City : NEW YORK
State : NY
Zip : 10021-4808
Country : US
Telephone Number : 312-213-0200
Fax Number :
Provider Business Practice Location Address
First Line : 8700 BEVERLY BLVD
Second Line :
City : WEST HOLLYWOOD
State : CA
Zip : 90048-1804
Country : US
Telephone Number : 310-423-6500
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/01/2011
Last Update Date : 03/02/2026

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Directions to “ DR. MAURICIO DE LA LAMA MD” Practice Location

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