Individual
LAURENCE CECILIO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
1200 B GALE WILSON BLVD, FAIRFIELD, CA 94533-3552
(707) 646-5000
Mailing address
5980 W 71ST ST STE 102, INDIANAPOLIS, IN 46278-1785
(317) 388-0800
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
95011502
CA
Other
Enumeration date
03/31/2014
Last updated
05/02/2019
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