Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NX0100X | Occupational Health | 67749673302 | CA |
NPI | 1821511494 |
---|---|
Provider Name | Paul Lauer |
First Address | Thousand Oaks, CA 91362-4916 |
Second Address | Thousand Oaks, CA 91362-4916 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/07/2017 |
Last Update Date | 25/07/2017 |