Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RR0500X | Rheumatology | G35549 | CA |
NPI | 1043208994 |
---|---|
Provider Name | George V Lawry II |
First Address | Orange, CA 92868-3201 |
Second Address | Orange, CA 92868-3201 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/10/2005 |
Last Update Date | 08/12/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00G355490 | (05) | CA |