Individual
DR. WILL HARLEY LANE
Active
Individual
DR. WILL HARLEY LANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
G30683
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00G306830
CA LICENSE
CA
Enumeration date
12/02/2005
Last updated
01/25/2018
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