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Individual

DR. ADRIANA ETHEL POLLAK LAZZARO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DO

Contact information

Practice address
1038 SOUTH GLENDORA AVE SUITE 2, WEST COVINA, CA 91790
(626) 814-2766
(626) 917-3009
Mailing address
1038 SOUTH GLENDORA AVE SUITE 2, WEST COVINA, CA 91790
(626) 814-2766
(626) 917-3009

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
20A6095
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00AX60950
CA
01
020A60950
BLUE SHIELD
CA
Enumeration date
11/01/2006
Last updated
07/08/2007
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