Provider Demographics
NPI:1538467477
Name:JUAREZ MORALES, LAURIE BETH (MD)
Entity Type:Individual
Prefix:DR
First Name:LAURIE BETH
Middle Name:
Last Name:JUAREZ MORALES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:504 S SIERRA MADRE BLVD
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91107-5240
Mailing Address - Country:US
Mailing Address - Phone:818-361-5437
Mailing Address - Fax:661-213-9828
Practice Address - Street 1:14426 GILMORE ST
Practice Address - Street 2:
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91401-1429
Practice Address - Country:US
Practice Address - Phone:818-361-5437
Practice Address - Fax:661-213-9828
Is Sole Proprietor?:No
Enumeration Date:2011-03-02
Last Update Date:2023-12-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA121331208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics