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Individual

OLEGARIO JAY LARA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
710 LAWRENCE EXPY DEPT 396, SANTA CLARA, CA 95051-5173
(408) 851-5067
Mailing address
710 LAWRENCE EXPY DEPT 396, SANTA CLARA, CA 95051-5173
(408) 851-5067

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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