Provider Demographics
NPI:1518131747
Name:LANCER, HAROLD ALLEN (MD, FAAD)
Entity Type:Individual
Prefix:DR
First Name:HAROLD
Middle Name:ALLEN
Last Name:LANCER
Suffix:
Gender:M
Credentials:MD, FAAD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9735 WILSHIRE BLVD ., PH
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90212
Mailing Address - Country:US
Mailing Address - Phone:310-278-8444
Mailing Address - Fax:310-278-7626
Practice Address - Street 1:9735 WILSHIRE BLVD PH
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90212-2104
Practice Address - Country:US
Practice Address - Phone:310-278-8444
Practice Address - Fax:310-278-7626
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-18
Last Update Date:2008-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG49309174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAC49309Medicare PIN
CAB50772Medicare UPIN