Provider Demographics
NPI:1689689044
Name:LAWTON, TENLEY K (MD)
Entity Type:Individual
Prefix:
First Name:TENLEY
Middle Name:K
Last Name:LAWTON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:TENLEY
Other - Middle Name:K
Other - Last Name:VORIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:16300 SAND CANYON AVE
Mailing Address - Street 2:SUITE 1011
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92618
Mailing Address - Country:US
Mailing Address - Phone:949-727-3999
Mailing Address - Fax:949-727-9053
Practice Address - Street 1:16300 SAND CANYON AVE
Practice Address - Street 2:SUITE 1011
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92618
Practice Address - Country:US
Practice Address - Phone:949-727-3999
Practice Address - Fax:949-727-9053
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2009-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA87428208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
I26503Medicare UPIN
A87428Medicare ID - Type Unspecified