Provider Demographics
NPI:1063477743
Name:LAWLER, CHRISTOPHER MARK (MD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:MARK
Last Name:LAWLER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:33422 GALLEON WAY
Mailing Address - Street 2:
Mailing Address - City:DANA POINT
Mailing Address - State:CA
Mailing Address - Zip Code:92629-1610
Mailing Address - Country:US
Mailing Address - Phone:949-770-2794
Mailing Address - Fax:949-305-3380
Practice Address - Street 1:32840 PACIFIC COAST HWY
Practice Address - Street 2:E
Practice Address - City:DANA POINT
Practice Address - State:CA
Practice Address - Zip Code:92629-3468
Practice Address - Country:US
Practice Address - Phone:949-770-2794
Practice Address - Fax:949-305-3380
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-18
Last Update Date:2015-10-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG55969208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAD99464Medicare UPIN