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Individual

LAURENCE J MAZZOTTA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
480 REDWOOD ST., STE. 14, VALLEJO, CA 94590-2958
(707) 648-3327
(707) 648-3902
Mailing address
480 REDWOOD ST., STE. 14, VALLEJO, CA 94590-2958
(707) 648-3327
(707) 648-3902

Taxonomy

Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
628907
CA
207RG0100X
Gastroenterology Physician
Primary
G28907
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00G289070
CA
Enumeration date
04/17/2006
Last updated
06/22/2010
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