Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | A105342 | CA |
N | 207QA0505X | Family Doctor - Adult Medicine | A105342 | CA |
N | 208D00000X | General Practice Physician | A105342 | CA |
NPI | 1063660421 |
---|---|
Provider Name | Roman Lal |
First Address | Torrance, CA 90505-3931 |
Second Address | Torrance, CA 90505-3931 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/08/2008 |
Last Update Date | 28/08/2008 |