Provider Demographics
NPI:1073692471
Name:MICHAEL B LAPPIN,MD,INC
Entity Type:Organization
Organization Name:MICHAEL B LAPPIN,MD,INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:BRUCE
Authorized Official - Last Name:LAPPIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:714-541-4185
Mailing Address - Street 1:801 N TUSTIN AVE
Mailing Address - Street 2:SUITE 700
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92705-3612
Mailing Address - Country:US
Mailing Address - Phone:714-541-4185
Mailing Address - Fax:714-541-3465
Practice Address - Street 1:801 N TUSTIN AVE
Practice Address - Street 2:SUITE 700
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92705-3612
Practice Address - Country:US
Practice Address - Phone:714-541-4185
Practice Address - Fax:714-541-3465
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-04
Last Update Date:2008-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC30285207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00C302851Medicaid
CAA34199Medicare UPIN
CAW21547Medicare PIN