Organization
GARY M LAZARUS OD PHD APC
Active
Other names
Gary M Lazarus OD or Gary M Lazarus OD Phd FAAD
Organization subpart
No
Provider details
NPI number
Authorized official
GARY MARC LAZARUS OD (OPTOMETRIST OWNER)
(310) 372-2197
Entity
Organization
Contact information
Practice address
806 MANHATTAN BEACH BLVD, SUITE 103, MANHATTAN BEACH, CA 90266-4960
(310) 372-2197
(310) 372-6581
Mailing address
806 MANHATTAN BEACH BLVD, SUITE 103, MANHATTAN BEACH, CA 90266-4960
(310) 372-2197
(310) 372-6581
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
5171T
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
32660VE
—
CA
01
—
SD0051710
BLUE SHILE OF CA
CA
05
—
SD0051710
—
CA
Enumeration date
11/21/2006
Last updated
07/09/2013
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