Provider Demographics
NPI:1740598382
Name:LAWRENCE J. LUPPI, M.D.
Entity Type:Organization
Organization Name:LAWRENCE J. LUPPI, M.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LAWRENCE
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:LUPPI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:949-206-0360
Mailing Address - Street 1:24953 PASEO DE VALENCIA STE 15B
Mailing Address - Street 2:
Mailing Address - City:LAGUNA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:92653-4339
Mailing Address - Country:US
Mailing Address - Phone:949-206-0360
Mailing Address - Fax:
Practice Address - Street 1:24953 PASEO DE VALENCIA STE 15B
Practice Address - Street 2:
Practice Address - City:LAGUNA HILLS
Practice Address - State:CA
Practice Address - Zip Code:92653-4339
Practice Address - Country:US
Practice Address - Phone:949-206-0360
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-16
Last Update Date:2010-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC36612207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty