Organization
BRUCE LAWRENCE MD PROF CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRUCE P LAWRENCE M.D. (PRESIDENT)
(510) 465-2500
Entity
Organization
Contact information
Practice address
445 30TH ST, 2ND FLOOR, OAKLAND, CA 94609-3301
(510) 465-2500
Mailing address
445 30TH ST, 2ND FLOOR, OAKLAND, CA 94609-3301
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
Primary
G24736
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G247360
—
CA
Enumeration date
09/29/2006
Last updated
05/29/2015
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