Provider Demographics
NPI:1760662886
Name:ROBERT R. LAWRENCE, M.D.
Entity Type:Organization
Organization Name:ROBERT R. LAWRENCE, M.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING SPECIALIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:J
Authorized Official - Last Name:CAPATOSTO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:661-947-3299
Mailing Address - Street 1:43847 HEATON AVE
Mailing Address - Street 2:SUITE I
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93534-4936
Mailing Address - Country:US
Mailing Address - Phone:661-947-3299
Mailing Address - Fax:661-947-3299
Practice Address - Street 1:43847 HEATON AVE
Practice Address - Street 2:SUITE I
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93534-4936
Practice Address - Country:US
Practice Address - Phone:661-947-3299
Practice Address - Fax:661-947-3299
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-06
Last Update Date:2007-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA18590174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW17817Medicare PIN
CAA21381Medicare UPIN