Organization
MICHAEL J. LAZAR, JR., M.D., PROFESSIONAL MEDICAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL J LAZAR M.D. (PRESIDENT)
(707) 546-5553
Entity
Organization
Contact information
Practice address
1140 SONOMA AVE, SUITE 1A, SANTA ROSA, CA 95405-4817
(707) 546-5553
(707) 546-0725
Mailing address
1140 SONOMA AVE, SUITE 1A, SANTA ROSA, CA 95405-4817
(707) 546-5553
(707) 546-0725
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00C409580
—
CA
Enumeration date
08/14/2006
Last updated
08/22/2020
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