Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VG0400X | Gynecologist | G9167 | CA |
NPI | 1164695953 |
---|---|
Provider Name | Dr. Leonard Laskow |
First Address | Ashland, OR 97520-3542 |
Second Address | Ashland, OR 97520-3542 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/04/2008 |
Last Update Date | 11/04/2008 |