Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251P0200X | Physical Therapist - Pediatrics | 23775 | CA |
NPI | 1013013861 |
---|---|
Provider Name | Mr. Lawrence Eric Lingren |
First Address | Westminster, CA 92683-2626 |
Second Address | Santa Ana, CA 92701-4134 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/09/2006 |
Last Update Date | 11/07/2007 |