Organization
EDWARD B LAZOR MD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EDWARD B LAZOR MD (OWNER PRESIDENT OF INC)
(323) 653-4220
Entity
Organization
Contact information
Practice address
6360 WILSHIRE BLVD, SUITE 202, LOS ANGELES, CA 90048-5601
(323) 653-4220
(323) 653-4222
Mailing address
6360 WILSHIRE BLVD, SUITE 202, LOS ANGELES, CA 90048-5601
(323) 653-4220
(323) 653-4222
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
C19592
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00C195920
—
CA
Enumeration date
12/22/2006
Last updated
02/21/2008
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