Provider Demographics
NPI:1932476322
Name:LAZARUS, VERONICA A (MD)
Entity Type:Individual
Prefix:DR
First Name:VERONICA
Middle Name:A
Last Name:LAZARUS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11226 HAYTER AVE
Mailing Address - Street 2:
Mailing Address - City:CULVER CITY
Mailing Address - State:CA
Mailing Address - Zip Code:90230-5333
Mailing Address - Country:US
Mailing Address - Phone:310-902-8543
Mailing Address - Fax:
Practice Address - Street 1:2001 WILSHIRE BLVD
Practice Address - Street 2:
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90403-5641
Practice Address - Country:US
Practice Address - Phone:310-902-8543
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-11-29
Last Update Date:2020-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA43363207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA95-4643269OtherOCCUPATIONAL MEDICINE PROVIDER