Provider Demographics
NPI:1093826992
Name:LASHER, MICHAEL E (DO)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:E
Last Name:LASHER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5051 VERDUGO WAY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:CAMARILLO
Mailing Address - State:CA
Mailing Address - Zip Code:93012-8680
Mailing Address - Country:US
Mailing Address - Phone:805-384-8071
Mailing Address - Fax:805-987-1927
Practice Address - Street 1:5051 VERDUGO WAY
Practice Address - Street 2:SUITE 100
Practice Address - City:CAMARILLO
Practice Address - State:CA
Practice Address - Zip Code:93012-8680
Practice Address - Country:US
Practice Address - Phone:805-384-8071
Practice Address - Fax:805-987-1927
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2021-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A8462207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1033357736Medicaid
CA1033399415Medicaid
CA113794255OtherIRS TAX ID
CAZZZ50355YOtherBS/TRIWEST
CA1093826992Medicaid
CA20A8462OtherCA LIC
CAZZZ55868YOtherBS/TRIWEST
CA113794255OtherIRS TAX ID
CA1093826992Medicaid
CAW21724Medicare PIN
CAZZZ50355YOtherBS/TRIWEST