Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | 20A12781 | CA |
N | 207N00000X | Dermatologist | 5101020094 | MI |
NPI | 1033464110 |
---|---|
Provider Name | Dr. Cynthia Chen Lazzaro |
First Address | Newport Beach, CA 92660-5524 |
Second Address | Newport Beach, CA 92660-5524 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/07/2012 |
Last Update Date | 23/12/2021 |