Individual
GARY PHILLIP LASK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
200 MEDICAL PLAZA, #450, LOS ANGELES, CA 90095-3075
(310) 825-0631
Mailing address
5767 W CENTURY BLVD, SUITE 200, LOS ANGELES, CA 90045-5632
(310) 825-0631
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
A35542
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A355420
—
CA
Enumeration date
07/10/2006
Last updated
04/01/2011
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