Provider Demographics
NPI:1508153842
Name:LAZARO, DIONISIO DUMBRIQUE (MD)
Entity Type:Individual
Prefix:
First Name:DIONISIO
Middle Name:DUMBRIQUE
Last Name:LAZARO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:18575 EAST GALE AVENUE
Mailing Address - Street 2:SUITE 155
Mailing Address - City:CITY OF INDUSTRY
Mailing Address - State:CA
Mailing Address - Zip Code:91748-1340
Mailing Address - Country:US
Mailing Address - Phone:626-581-8960
Mailing Address - Fax:626-581-8536
Practice Address - Street 1:18575 EAST GALE AVENUE
Practice Address - Street 2:SUITE 155
Practice Address - City:CITY OF INDUSTRY
Practice Address - State:CA
Practice Address - Zip Code:91748-1340
Practice Address - Country:US
Practice Address - Phone:626-581-8960
Practice Address - Fax:626-581-8536
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-07
Last Update Date:2020-02-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA48512207R00000X, 2083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine