Individual
MARY LOU LAO DAVID
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
22 BLUFF COVE DR, ALISO VIEJO, CA 92656-8077
(949) 360-0587
Mailing address
4050 BARRANCA PKWY, IRVINE, CA 92604-7706
(949) 551-1090
(949) 262-5500
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
18743
CA
363LP2300X
Primary Care Nurse Practitioner
Primary
18743
CA
Other
Enumeration date
06/19/2009
Last updated
10/26/2017
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