Provider Demographics
NPI:1609867506
Name:AUGUST, LAWRENCE N (MD)
Entity Type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:N
Last Name:AUGUST
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:520 N PROSPECT AVE
Mailing Address - Street 2:SUITE 206
Mailing Address - City:REDONDO BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90277-3041
Mailing Address - Country:US
Mailing Address - Phone:310-376-8850
Mailing Address - Fax:310-798-9228
Practice Address - Street 1:520 N PROSPECT AVE
Practice Address - Street 2:SUITE 206
Practice Address - City:REDONDO BEACH
Practice Address - State:CA
Practice Address - Zip Code:90277-3041
Practice Address - Country:US
Practice Address - Phone:310-376-8850
Practice Address - Fax:310-798-9228
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-31
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
CAG27303207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G273030Medicaid
CA00G273030Medicaid
CAA43310Medicare UPIN