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NPI Code Detail

MEDICARE: WILL H. LANE, MD, INC

MEDICARE: WILL H. LANE, MD, INC
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
1174400000XSpecialist00G306830CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11548244684OTHERCANPI

General Provider Information

NPI Number : 1669791455
Entity Type Code : Organization
Provider Name (Legal Business Name) : WILL H. LANE, MD, INC
Provider Business Mailing Address
First Line : 120 LA CASA VIA
Second Line : STE 107
City : WALNUT CREEK
State : CA
Zip : 94598-3067
Country : US
Telephone Number : 925-935-1880
Fax Number : 925-935-2641
Provider Business Practice Location Address
First Line : 120 LA CASA VIA
Second Line : STE 107
City : WALNUT CREEK
State : CA
Zip : 94598-3067
Country : US
Telephone Number : 925-935-1880
Fax Number : 925-935-2641
Authorized Official
Title or Position : PRESIDENT/ SOLE OWNER
Name : DR. WILL HARLEY LANE
Credential : M.D
Telephone Number : 925-935-1880
Provider Enumeration Date : 05/19/2010
Last Update Date : 05/19/2010

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Directions to “WILL H. LANE, MD, INC ” Practice Location

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