Provider Demographics
NPI:1093871600
Name:CARNOW, LAWRENCE EDWARD (DPM)
Entity Type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:EDWARD
Last Name:CARNOW
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 S CAMDEN DR
Mailing Address - Street 2:#7
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90212-4250
Mailing Address - Country:US
Mailing Address - Phone:562-818-8272
Mailing Address - Fax:
Practice Address - Street 1:401 S CAMDEN DR
Practice Address - Street 2:#7
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90212-4250
Practice Address - Country:US
Practice Address - Phone:562-818-8272
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-28
Last Update Date:2010-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE2119213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA000E21190Medicaid
CAE2119Medicare UPIN