Individual
CALLUM LAVOIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4650 W SUNSET BLVD, LOS ANGELES, CA 90027-6062
(780) 717-2622
Mailing address
1137 N CENTRAL AVE APT 1520, GLENDALE, CA 91202-3683
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
A188417
CA
2088P0231X
Pediatric Urology Physician
A188417
CA
Other
Enumeration date
08/10/2023
Last updated
08/10/2023
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