Individual
DR. CONNIE J LANE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
11080 W OLYMPIC BLVD, LOS ANGELES, CA 90064-1937
(310) 966-6523
(310) 231-0764
Mailing address
11080 W OLYMPIC BLVD, LOS ANGELES, CA 90064-1937
(310) 966-6523
(310) 231-0764
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
A87503
CA
Other
Enumeration date
10/19/2006
Last updated
07/08/2007
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