Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0106X | Oral and Maxillofacial Pathology | 25937 | CA |
NPI | 1851474902 |
---|---|
Provider Name | Lawrence P. Lorenzi |
First Address | Newport Beach, CA 92660-5324 |
Second Address | Palm Desert, CA 92260-4141 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/10/2006 |
Last Update Date | 20/12/2021 |