Provider Demographics
NPI:1730496902
Name:LATHROP, DONALD BRANUM (MD)
Entity Type:Individual
Prefix:
First Name:DONALD
Middle Name:BRANUM
Last Name:LATHROP
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:472 KNOLL DR
Mailing Address - Street 2:
Mailing Address - City:LOS ALTOS
Mailing Address - State:CA
Mailing Address - Zip Code:94024-4731
Mailing Address - Country:US
Mailing Address - Phone:650-949-3353
Mailing Address - Fax:
Practice Address - Street 1:472 KNOLL DR
Practice Address - Street 2:
Practice Address - City:LOS ALTOS
Practice Address - State:CA
Practice Address - Zip Code:94024-4731
Practice Address - Country:US
Practice Address - Phone:650-949-3353
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-08
Last Update Date:2010-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACFE23960208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics