Individual
EDWARD PAUL LAINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
2036 RAILROAD AVE, REDDING, CA 96001-1801
(530) 255-1000
Mailing address
2036 RAILROAD AVE, REDDING, CA 96001-1801
(530) 255-1000
Taxonomy
Speciality
Code
Description
License number
State
207ZB0001X
Blood Banking & Transfusion Medicine Physician
5101012103
MI
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
05-28923
KS
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
1857
NE
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
5101012103
MI
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
6623
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2152210364
BCBSM
MI
Enumeration date
01/23/2006
Last updated
07/19/2023
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