Provider Demographics
NPI:1912361072
Name:MATHIAS, LAUREN MARIE (MD)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:MARIE
Last Name:MATHIAS
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:550 N ATLANTIC BLVD UNIT 261
Mailing Address - Street 2:
Mailing Address - City:MONTEREY PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91754-7737
Mailing Address - Country:US
Mailing Address - Phone:405-401-6919
Mailing Address - Fax:
Practice Address - Street 1:11480 BROOKSHIRE AVE STE 204
Practice Address - Street 2:
Practice Address - City:DOWNEY
Practice Address - State:CA
Practice Address - Zip Code:90241-5023
Practice Address - Country:US
Practice Address - Phone:562-904-4466
Practice Address - Fax:562-904-4466
Is Sole Proprietor?:No
Enumeration Date:2016-04-05
Last Update Date:2021-08-13
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA155072207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CALM3232267556Medicaid