Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RP1001X | Pulmonary Disease | A81589 | CA |
NPI | 1043382278 |
---|---|
Provider Name | Dr. Lawrence R Tom |
First Address | Harbor City, CA 90710-3518 |
Second Address | Harbor City, CA 90710-3518 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/11/2006 |
Last Update Date | 14/12/2021 |