Provider Demographics
NPI:1336434224
Name:LAWRENCE, TODD C (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:TODD
Middle Name:C
Last Name:LAWRENCE
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26762 PORTOLA PKWY
Mailing Address - Street 2:
Mailing Address - City:FOOTHILL RANCH
Mailing Address - State:CA
Mailing Address - Zip Code:92610-1712
Mailing Address - Country:US
Mailing Address - Phone:949-454-0327
Mailing Address - Fax:949-454-0327
Practice Address - Street 1:26762 PORTOLA PKWY
Practice Address - Street 2:
Practice Address - City:FOOTHILL RANCH
Practice Address - State:CA
Practice Address - Zip Code:92610-1712
Practice Address - Country:US
Practice Address - Phone:949-454-0327
Practice Address - Fax:949-454-0327
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-18
Last Update Date:2011-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA46439183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist