Provider Demographics
NPI:1699857268
Name:BATTAD, LAWRENCE ROSARIO (NP)
Entity Type:Individual
Prefix:
First Name:LAWRENCE
Middle Name:ROSARIO
Last Name:BATTAD
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4910 E CLINTON WAY
Mailing Address - Street 2:SUITE 101
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93727-1560
Mailing Address - Country:US
Mailing Address - Phone:559-443-2682
Mailing Address - Fax:559-443-2681
Practice Address - Street 1:2335 E KASHIAN LN
Practice Address - Street 2:SUITE 301
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93701-2230
Practice Address - Country:US
Practice Address - Phone:559-320-0530
Practice Address - Fax:559-320-0532
Is Sole Proprietor?:No
Enumeration Date:2006-10-20
Last Update Date:2011-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARN532391163W00000X
CANP12648363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
CARN532391Medicaid
CABP597YOtherPTAN
CANPF12648Medicare PIN
CARN532391Medicaid