Provider Demographics
NPI:1578643847
Name:WILLIAM G LANG MD A PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:WILLIAM G LANG MD A PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:G
Authorized Official - Last Name:LANG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-536-8200
Mailing Address - Street 1:4644 LINCOLN BLVD.
Mailing Address - Street 2:SUITE 111
Mailing Address - City:MARINA DEL REY
Mailing Address - State:CA
Mailing Address - Zip Code:90292-6374
Mailing Address - Country:US
Mailing Address - Phone:310-536-8200
Mailing Address - Fax:310-536-8240
Practice Address - Street 1:4644 LINCOLN BLVD.
Practice Address - Street 2:SUITE 111
Practice Address - City:MARINA DEL REY
Practice Address - State:CA
Practice Address - Zip Code:90292-6374
Practice Address - Country:US
Practice Address - Phone:310-536-8200
Practice Address - Fax:310-536-8240
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-17
Last Update Date:2013-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty