Individual
DR. LAURENCE ATHOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
19830 LAKE CHABOT RD, SUITE D, CASTRO VALLEY, CA 94546-4063
(510) 889-1677
(510) 889-5823
Mailing address
19830 LAKE CHABOT RD, SUITE D, CASTRO VALLEY, CA 94546-4063
(510) 889-1677
(510) 889-5823
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
G34546
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G345460
—
CA
Enumeration date
11/15/2006
Last updated
07/08/2007
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