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Individual

LAWRENCE MIETUS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
5662 CALLE REAL, SUITE 341, GOLETA, CA 93117-2317
(805) 886-7914
Mailing address
5662 CALLE REAL, SUITE 341, GOLETA, CA 93117-2317
(805) 886-7914

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
G60991
CA

Other

Enumeration date
12/16/2006
Last updated
07/09/2007
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