Provider Demographics
NPI:1952551608
Name:PLATT, LAURENCE JAMES (MD)
Entity Type:Individual
Prefix:DR
First Name:LAURENCE
Middle Name:JAMES
Last Name:PLATT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:565 BELLEVUE AVE
Mailing Address - Street 2:1607
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94610-5034
Mailing Address - Country:US
Mailing Address - Phone:510-272-9300
Mailing Address - Fax:
Practice Address - Street 1:565 BELLEVUE AVE
Practice Address - Street 2:1607
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94610-5034
Practice Address - Country:US
Practice Address - Phone:510-272-9300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-30
Last Update Date:2008-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD17785(INACTIVE)2083P0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine