Provider Demographics
NPI:1811029200
Name:LAWRENCE WERLIN MD INC
Entity Type:Organization
Organization Name:LAWRENCE WERLIN MD INC
Other - Org Name:COASTAL FERTILITY MEDICAL CENTER INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BILLING DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:LAUREN
Authorized Official - Middle Name:C
Authorized Official - Last Name:PARROTT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-726-0682
Mailing Address - Street 1:4900 BARRANCA PKWY
Mailing Address - Street 2:SUITE 103
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92604
Mailing Address - Country:US
Mailing Address - Phone:949-726-0600
Mailing Address - Fax:949-726-0601
Practice Address - Street 1:4900 BARRANCA PKWY
Practice Address - Street 2:SUITE 103
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92604
Practice Address - Country:US
Practice Address - Phone:949-726-0600
Practice Address - Fax:949-726-0601
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-12
Last Update Date:2008-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR=========OtherTAX ID