Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207VG0400X | Gynecologist | G39292 | CA |
Y | 207VX0000X | Obstetrician | G39292 | CA |
NPI | 1306860861 |
---|---|
Provider Name | Dr. Steven Craig Lazaro |
First Address | Chico, CA 95926-3312 |
Second Address | Chico, CA 95926-3312 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/07/2006 |
Last Update Date | 26/11/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
94-2708011 | TAX ID (01) | CA |
A47773 | (02) | CA |
AL8693067 | DEA LICENSE (01) | CA |
G39292 | MEDICAL LICENSE (01) | CA |
GROO43570 | (05) | CA |