Individual
DR. LAZARO GUROVICH WISNIA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
880 S ATLANTIC BLVD, #302, MONTEREY PARK, CA 91754-4700
(626) 576-8040
(626) 576-8079
Mailing address
880 S ATLANTIC BLVD, #302, MONTEREY PARK, CA 91754-4700
(626) 576-8040
(626) 576-8079
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
A32074
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A320741
—
CA
Enumeration date
11/29/2005
Last updated
07/09/2007
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