Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 35.089269 | OH |
N | 2080N0001X | Neonatal-Perinatal Doctor | 060400 | GA |
Y | 2080N0001X | Neonatal-Perinatal Doctor | A116763 | CA |
NPI | 1023152196 |
---|---|
Provider Name | Dr. Adrian P Lavery |
First Address | Loma Linda, CA 92354 |
Second Address | Loma Linda, CA 92354 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/02/2007 |
Last Update Date | 24/03/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
I05664 | (02) |