Individual
DR. CAROLYN SMITH LACEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1450 TREAT BLVD, SUITE 220B, WALNUT CREEK, CA 94597-2168
(925) 937-1770
(925) 937-0630
Mailing address
DEPT 34929, P.O. BOX 39000, SAN FRANCISCO, CA 94139-0001
(925) 952-2828
(925) 952-2850
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
0101238189
VA
207RC0000X
Cardiovascular Disease Physician
Primary
C131968
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P01474765
RAILROAD MEDICARE
CA
Enumeration date
11/15/2005
Last updated
08/11/2015
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