Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 170100000X | Medical Geneticist | CA |
NPI | 1366590986 |
---|---|
Provider Name | Dr. Lawrence John Coates |
First Address | Lancaster, CA 93534-3101 |
Second Address | Lancaster, CA 93534-3101 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/01/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
PSY. 10063 | LICENSED PSYCHOLOGIST (01) | CA |