Provider Demographics
NPI:1508863150
Name:SHERWIN, LAWRENCE ARNOLD (MD)
Entity Type:Individual
Prefix:MR
First Name:LAWRENCE
Middle Name:ARNOLD
Last Name:SHERWIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 N TUSTIN AVE
Mailing Address - Street 2:STE G
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92705-3605
Mailing Address - Country:US
Mailing Address - Phone:714-547-6111
Mailing Address - Fax:714-547-0833
Practice Address - Street 1:800 N TUSTIN AVE
Practice Address - Street 2:STE G
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92705-3605
Practice Address - Country:US
Practice Address - Phone:714-547-6111
Practice Address - Fax:714-547-0833
Is Sole Proprietor?:No
Enumeration Date:2005-06-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA23310207ND0900X, 207NI0002X, 207NS0135X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207ND0900XAllopathic & Osteopathic PhysiciansDermatologyDermatopathology
Not Answered207NI0002XAllopathic & Osteopathic PhysiciansDermatologyClinical & Laboratory Dermatological Immunology
Not Answered207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural Dermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
W18116Medicare ID - Type Unspecified
A82783Medicare UPIN