Individual
LAUREL LACKEY BRANCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
9350 CAMPUS POINT DR, LA JOLLA, CA 92037-1300
(800) 926-8273
Mailing address
FILE 57326, LOS ANGELES, CA 90074-0001
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
51154
SC
207RG0100X
Gastroenterology Physician
Primary
A172755
CA
Other
Enumeration date
06/14/2017
Last updated
10/23/2025
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