Individual
MR. EDGAR D LARDIZABAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1705 CRANBROOK CT, LATHROP, CA 95330-8244
(510) 332-2259
Mailing address
1705 CRANBROOK CT, LATHROP, CA 95330-8244
(510) 332-2259
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
694768
CA
Other
Enumeration date
03/30/2020
Last updated
03/30/2020
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