Michael T Lardon Md Apc | |
3750 Convoy St Ste 318 San Diego CA 92111-3741 | |
(858) 292-2929 | |
(858) 292-2909 |
Full Name | Michael T Lardon Md Apc |
---|---|
Speciality | Psychiatry & Neurology |
Location | 3750 Convoy St Ste 318, San Diego, California |
Authorized Official Name and Position | Michael Theodore Lardon (CEO/OWNER) |
Authorized Official Contact | 8582922929 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Michael T Lardon Md Apc 3750 Convoy St Ste 318 San Diego CA 92111-3741 Ph: (858) 292-2929 | Michael T Lardon Md Apc 3750 Convoy St Ste 318 San Diego CA 92111-3741 Ph: (858) 292-2929 |
NPI Number | 1861035495 |
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Provider Enumeration Date | 10/27/2019 |
Last Update Date | 01/03/2020 |
Certification Date | 01/03/2020 |
Medicare PECOS PAC ID | 3274961479 |
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Medicare Enrollment ID | O20200323001721 |
Identifier | Type | State | Issuer |
---|---|---|---|
1861035495 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
Provider Name | Michael T Lardon |
---|---|
Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1174630305 PECOS PAC ID: 5092604835 Enrollment ID: I20051229000798 |
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