Provider Demographics
NPI:1073598223
Name:LAZARUS, NANCY BARBARA (MD)
Entity Type:Individual
Prefix:DR
First Name:NANCY
Middle Name:BARBARA
Last Name:LAZARUS
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 1:51 COLLEGE PARK
Mailing Address - Street 2:
Mailing Address - City:DAVIS
Mailing Address - State:CA
Mailing Address - Zip Code:95616-3643
Mailing Address - Country:US
Mailing Address - Phone:530-792-0731
Mailing Address - Fax:
Practice Address - Street 1:150 MUIR RD
Practice Address - Street 2:VANCHCS
Practice Address - City:MARTINEZ
Practice Address - State:CA
Practice Address - Zip Code:94553-4668
Practice Address - Country:US
Practice Address - Phone:707-437-1800
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG39904207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine