Organization
LAZARO WISNIA, M.D., INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAZARO G. WISNIA M.D (MEDICAL DOCTOR/DIRECTOR)
(626) 576-8040
Entity
Organization
Contact information
Practice address
880 S ATLANTIC BLVD, SUITE 302, MONTEREY PARK, CA 91754-4700
(626) 576-8040
(626) 576-4186
Mailing address
880 S ATLANTIC BLVD, SUITE 302, MONTEREY PARK, CA 91754-4700
(626) 576-8040
(626) 576-4186
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
A32074
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A320741
—
CA
Enumeration date
10/04/2006
Last updated
08/22/2020
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