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Organization
LAWRENCE A. MORA MD INC
Active
Organization
LAWRENCE A. MORA MD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAWRENCE A MORA MD (PRESIDENT)
(323) 456-0185
Entity
Organization
Contact information
Practice address
5901 W OLYMPIC BLVD STE 404, LOS ANGELES, CA 90036-4669
(323) 456-0185
(323) 443-1744
Mailing address
5901 W OLYMPIC BLVD STE 404, LOS ANGELES, CA 90036-4669
(323) 456-0185
(323) 443-1744
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00A713990
BLUE SHIELD
CA
05
—
1912930512
—
CA
Enumeration date
07/08/2006
Last updated
02/24/2021
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