Provider Demographics
NPI:1023096831
Name:MORGAN, LAURA R (MD)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:R
Last Name:MORGAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:LAURA
Other - Middle Name:R
Other - Last Name:FLETCHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:36921 COOK ST
Mailing Address - Street 2:SUITE 102
Mailing Address - City:PALM DESERT
Mailing Address - State:CA
Mailing Address - Zip Code:92211-6070
Mailing Address - Country:US
Mailing Address - Phone:760-836-9066
Mailing Address - Fax:760-836-9066
Practice Address - Street 1:36-921 COOK STREET
Practice Address - Street 2:SUITE 102
Practice Address - City:PALM DESERT
Practice Address - State:CA
Practice Address - Zip Code:92211-6070
Practice Address - Country:US
Practice Address - Phone:760-836-9066
Practice Address - Fax:760-836-9066
Is Sole Proprietor?:No
Enumeration Date:2006-01-03
Last Update Date:2012-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA651591207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G515911Medicare PIN
A07324Medicare UPIN