Provider Demographics
NPI:1023105335
Name:GIST, LAUREN (MD)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:
Last Name:GIST
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:3880 MURPHY CANYON RD.
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92123-4411
Mailing Address - Country:US
Mailing Address - Phone:858-636-4300
Mailing Address - Fax:858-636-4319
Practice Address - Street 1:7910 FROST ST.
Practice Address - Street 2:SUITE 360
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92123-2776
Practice Address - Country:US
Practice Address - Phone:858-246-0053
Practice Address - Fax:858-496-9257
Is Sole Proprietor?:No
Enumeration Date:2006-10-06
Last Update Date:2025-01-31
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Provider Licenses
StateLicense IDTaxonomies
CAA813812080P0006X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0006XAllopathic & Osteopathic PhysiciansPediatricsDevelopmental - Behavioral Pediatrics
No208000000XAllopathic & Osteopathic PhysiciansPediatrics