Provider Demographics
NPI:1295976520
Name:LACARIA, TERESA M (MD)
Entity type:Individual
Prefix:DR
First Name:TERESA
Middle Name:M
Last Name:LACARIA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:10833 LE CONTE AVE, 13-145G CHS
Mailing Address - Street 2:DAVID GEFFEN SCHOOL OF MEDICINE, UCLA
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90095-1732
Mailing Address - Country:US
Mailing Address - Phone:310-825-5719
Mailing Address - Fax:
Practice Address - Street 1:10833 LE CONTE AVE
Practice Address - Street 2:DAVID GEFFEN SCHOOL OF MEDICINE, UCLA
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90095-3075
Practice Address - Country:US
Practice Address - Phone:310-825-5719
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-03-17
Last Update Date:2009-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA103615207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology