Provider Demographics
NPI:1649386673
Name:LAURIER J. TREMBLAY, JR., M.D., F.A.C.S., A.P.C.
Entity Type:Organization
Organization Name:LAURIER J. TREMBLAY, JR., M.D., F.A.C.S., A.P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LAURIER
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:TREMBLAY
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:858-279-3984
Mailing Address - Street 1:5070 CORTE PLAYA CATALINA
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92124-1556
Mailing Address - Country:US
Mailing Address - Phone:858-279-3984
Mailing Address - Fax:
Practice Address - Street 1:5070 CORTE PLAYA CATALINA
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92124-1556
Practice Address - Country:US
Practice Address - Phone:858-279-3984
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-22
Last Update Date:2012-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG47379208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty