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Individual

LAWRENCE GORDON FOSTER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
58581 US HIGHWAY 371, STE F, G, H, ANZA, CA 92539-9331
(951) 763-4759
Mailing address
230 HOSPITAL DR STE B, UKIAH, CA 95482-4563
(707) 463-3501

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
2534A
WY
208600000X
Surgery Physician
35.042130
OH
208600000X
Surgery Physician
Primary
A34957
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0A349570
CA
Enumeration date
07/14/2006
Last updated
05/26/2015
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