Provider Demographics
NPI:1750306171
Name:MARSHALL, LAWRENCE F (MD)
Entity Type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:F
Last Name:MARSHALL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 232410
Mailing Address - Street 2:UCSD MEDICAL CENTER
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92193-2410
Mailing Address - Country:US
Mailing Address - Phone:858-249-6749
Mailing Address - Fax:
Practice Address - Street 1:200 WEST ARBOR DR - MC 8893
Practice Address - Street 2:UCSD MEDICAL CENTER
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92103-8893
Practice Address - Country:US
Practice Address - Phone:619-543-3500
Practice Address - Fax:619-543-6808
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2017-02-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAC36547207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00C365470Medicaid
CAA36301Medicare UPIN
CA00C365470Medicaid