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Organization
LOWELL P THEARD MD INC
Active
Organization
LOWELL P THEARD MD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LOWELL P THEARD MD (PRESIDENT)
(310) 838-6801
Entity
Organization
Contact information
Practice address
3831 HUGHES AVE, 705, CULVER CITY, CA 90232-2751
(310) 838-6801
(310) 838-5385
Mailing address
4206 DON TAPIA PL, LOS ANGELES, CA 90008-4236
(310) 838-6801
(310) 838-5385
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
G37108
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1023065992
—
CA
Enumeration date
05/27/2006
Last updated
09/27/2013
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