Organization
LAURENCE J. MAZZOTTA MD PC
Active
Organization
LAURENCE J. MAZZOTTA MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAURENCE J MAZZOTTA MD (SOLE PROPRIETOR)
(707) 648-3327
Entity
Organization
Contact information
Practice address
480 REDWOOD ST, SUITE 14, VALLEJO, CA 94590-2958
(707) 648-3327
(707) 648-3902
Mailing address
480 REDWOOD ST, SUITE 14, VALLEJO, CA 94590-2958
(707) 648-3327
(707) 648-3902
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
G28907
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G289070
—
CA
Enumeration date
11/14/2007
Last updated
10/06/2010
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