Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175F00000X | Naturopath | ND-560 | CA |
NPI | 1003150434 |
---|---|
Provider Name | Dr. Derek Lawrence |
First Address | Carlsbad, CA 92008-2363 |
Second Address | Carlsbad, CA 92008-2363 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/11/2012 |
Last Update Date | 26/03/2021 |