Provider Demographics
NPI:1477088979
Name:LAZZARINI, THOMAS ADRIANO MCINNES (MD)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:ADRIANO MCINNES
Last Name:LAZZARINI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:41900 WINCHESTER RD STE 201
Mailing Address - Street 2:
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92590-3426
Mailing Address - Country:US
Mailing Address - Phone:951-566-9761
Mailing Address - Fax:951-672-6667
Practice Address - Street 1:41900 WINCHESTER RD STE 201
Practice Address - Street 2:
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92590-3426
Practice Address - Country:US
Practice Address - Phone:951-679-0400
Practice Address - Fax:951-672-6667
Is Sole Proprietor?:No
Enumeration Date:2017-04-22
Last Update Date:2023-11-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA191729207W00000X, 207WX0107X
FLME150161207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina Specialist
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmology