Provider Demographics
NPI:1861651085
Name:OBERSTEIN, LAWRENCE BRIAN
Entity Type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:BRIAN
Last Name:OBERSTEIN
Suffix:
Gender:M
Credentials:
Other - Prefix:DR
Other - First Name:LARRY
Other - Middle Name:
Other - Last Name:OBERSTEIN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:7765 HEALDSBURG AVE
Mailing Address - Street 2:SUITE 14
Mailing Address - City:SEBASTOPOL
Mailing Address - State:CA
Mailing Address - Zip Code:95472-3309
Mailing Address - Country:US
Mailing Address - Phone:707-824-9344
Mailing Address - Fax:707-824-9343
Practice Address - Street 1:7765 HEALDSBURG AVE
Practice Address - Street 2:SUITE 14
Practice Address - City:SEBASTOPOL
Practice Address - State:CA
Practice Address - Zip Code:95472-3309
Practice Address - Country:US
Practice Address - Phone:707-824-9344
Practice Address - Fax:707-824-9343
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-03
Last Update Date:2008-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA16787111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician