Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | E3142 | CA |
Y | 222Z00000X | Podiatrist | E3142 | CA |
NPI | 1013953058 |
---|---|
Provider Name | Lawrence A Brown |
First Address | Newport Beach, CA 92663-3600 |
Second Address | Newport Beach, CA 92663-3600 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/06/2006 |
Last Update Date | 13/02/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
T19277 | (02) |