Individual
ROBERT LAZARUS MODLIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
200 MEDICAL PLAZA SUITE 450, LOS ANGELES, CA 90095-3075
(310) 825-6911
(310) 794-7005
Mailing address
5767 W CENTURY BLVD STE 400, LOS ANGELES, CA 90045-5631
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
G46803
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G468030
—
CA
Enumeration date
07/10/2006
Last updated
11/22/2019
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