Provider Demographics
NPI:1629390901
Name:MAYER, LAWRENCE MALCOLM (MD)
Entity Type:Individual
Prefix:
First Name:LAWRENCE
Middle Name:MALCOLM
Last Name:MAYER
Suffix:
Gender:M
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:25775 MCBEAN PKWY
Mailing Address - Street 2:209
Mailing Address - City:VALENCIA
Mailing Address - State:CA
Mailing Address - Zip Code:91355-3708
Mailing Address - Country:US
Mailing Address - Phone:661-222-7272
Mailing Address - Fax:661-254-2828
Practice Address - Street 1:25775 MCBEAN PKWY
Practice Address - Street 2:209
Practice Address - City:VALENCIA
Practice Address - State:CA
Practice Address - Zip Code:91355-3708
Practice Address - Country:US
Practice Address - Phone:661-222-7272
Practice Address - Fax:661-254-2828
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-27
Last Update Date:2024-03-02
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Provider Licenses
StateLicense IDTaxonomies
CAG22803208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice