Provider Demographics
NPI:1043375850
Name:GREENBERG, LAUREN (MD)
Entity Type:Individual
Prefix:DR
First Name:LAUREN
Middle Name:
Last Name:GREENBERG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:750 WELCH RD
Mailing Address - Street 2:SUITE 117
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94304-1507
Mailing Address - Country:US
Mailing Address - Phone:650-617-9907
Mailing Address - Fax:650-617-9909
Practice Address - Street 1:750 WELCH RD
Practice Address - Street 2:SUITE 117
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94304-1507
Practice Address - Country:US
Practice Address - Phone:650-617-9907
Practice Address - Fax:650-617-9909
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAO55111208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery