Individual
DR. TRACY DEBRA LAWRENCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1520 SAN PABLO ST, SUITE 1000, LOS ANGELES, CA 90033-5310
(323) 442-5100
Mailing address
PO BOX 31309, LOS ANGELES, CA 90031-0309
(323) 442-5100
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
A73940
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00A739400
BLUE SHIELD
CA
05
—
00A739400
—
CA
01
—
00A739400197
CAL OPTIMA
CA
01
—
1356390009
GROUP NPI
CA
01
—
CE1617
GROUP RAILROAD MEDICARE
CA
01
—
GR0016910
GROUP MEDICAID PIN
CA
01
—
P00407895
RAILROAD MEDICARE
CA
01
—
W11675
GROUP MEDICARE PIN
CA
Enumeration date
06/30/2006
Last updated
03/10/2017
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