Provider Demographics
NPI:1073773909
Name:NORDHOFF, LAWRENCE STROUD JR (DC)
Entity Type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:STROUD
Last Name:NORDHOFF
Suffix:JR
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4133 MOHR AVE
Mailing Address - Street 2:SUITE F
Mailing Address - City:PLEASANTON
Mailing Address - State:CA
Mailing Address - Zip Code:94566-4678
Mailing Address - Country:US
Mailing Address - Phone:925-484-2928
Mailing Address - Fax:925-484-8443
Practice Address - Street 1:4133 MOHR AVE
Practice Address - Street 2:SUITE F
Practice Address - City:PLEASANTON
Practice Address - State:CA
Practice Address - Zip Code:94566-4678
Practice Address - Country:US
Practice Address - Phone:925-484-2928
Practice Address - Fax:925-484-8443
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-13
Last Update Date:2008-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA016654111N00000X, 111NI0013X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NI0013XChiropractic ProvidersChiropractorIndependent Medical Examiner
Provider Identifiers
StateIdentifier IDID TypeIssuer
123733600OtherDOL