Provider Demographics
NPI:1912232075
Name:TENLEY K. LAWTON, M.D., INC.
Entity Type:Organization
Organization Name:TENLEY K. LAWTON, M.D., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:TENLEY
Authorized Official - Middle Name:K
Authorized Official - Last Name:LAWTON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:714-527-1082
Mailing Address - Street 1:180 NEWPORT CENTER DR
Mailing Address - Street 2:SUITE 170
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-6972
Mailing Address - Country:US
Mailing Address - Phone:714-527-1082
Mailing Address - Fax:714-527-1396
Practice Address - Street 1:180 NEWPORT CENTER DR
Practice Address - Street 2:SUITE 170
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-6972
Practice Address - Country:US
Practice Address - Phone:714-527-1082
Practice Address - Fax:714-527-1396
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-07
Last Update Date:2009-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA87428208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
I26503Medicare UPIN
A87428Medicare PIN