Individual
DR. LAWRENCE BENNETT SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
375 LAGUNA HONDA BLVD, LAGUNA HONDA HOSPITAL AND REHAB CENTER, MEDICAL SVCS, SAN FRANCISCO, CA 94116-1411
(415) 759-4573
(415) 759-2390
Mailing address
375 LAGUNA HONDA BLVD, LAGUNA HONDA HOSPITAL AND REHAB CTR, MEDICAL SVCS, SAN FRANCISCO, CA 94116-1411
(415) 759-2300
(415) 759-2374
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PSY13051
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PSY130510
—
CA
Enumeration date
02/20/2007
Last updated
07/08/2007
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