Individual
OLEGARIO JAY LARA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
20A6671
CA
2085R0202X
Diagnostic Radiology Physician
Primary
OS22082
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00AX66710
MEDICAL
CA
Enumeration date
07/06/2006
Last updated
11/03/2025
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