Individual
DR. LAWRENCE EDWARD WELLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
501 S BUENA VISTA ST, BURBANK, CA 91505-4809
(818) 843-5111
(405) 749-4561
Mailing address
PO BOX 80116, CITY OF INDUSTRY, CA 91716-8116
(800) 749-4560
(405) 749-4561
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
A49234
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00A492340
BLUE SHIELD
—
05
—
00A492340
—
CA
01
—
A49234
BLUE CROSS
—
Enumeration date
04/12/2006
Last updated
12/01/2021
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