Individual
DR. LAWRENCE S MIHALAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
11645 WILSHIRE BLVD, 988, LOS ANGELES, CA 90025-1708
(310) 820-1561
(310) 826-0895
Mailing address
11645 WILSHIRE BLVD, SUITE. 988, LOS ANGELES, CA 90025-1708
(310) 820-1561
(310) 826-0895
Taxonomy
Speciality
Code
Description
License number
State
207KA0200X
Allergy Physician
Primary
G29836
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
G29836
STATE LICENSE NUMBER
CA
Enumeration date
10/29/2007
Last updated
03/07/2023
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