Provider Demographics
NPI:1134740327
Name:LANOI MEDICAL GROUP
Entity type:Organization
Organization Name:LANOI MEDICAL GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:BART
Authorized Official - Middle Name:
Authorized Official - Last Name:CALAME
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:858-900-2710
Mailing Address - Street 1:6605 NANCY RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92121-2253
Mailing Address - Country:US
Mailing Address - Phone:858-900-2710
Mailing Address - Fax:858-750-2984
Practice Address - Street 1:6605 NANCY RIDGE DR
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92121-2253
Practice Address - Country:US
Practice Address - Phone:858-900-2710
Practice Address - Fax:858-750-2984
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COMPASS DERMATOPATHOLOGY, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-04-29
Last Update Date:2020-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty