| Bruce Lawrence Md Prof Corp | |
|
445 30th St 2nd Floor Oakland CA 94609-3301 | |
| (510) 465-2500 | |
| Not Available |
| Full Name | Bruce Lawrence Md Prof Corp |
|---|---|
| Speciality | Family Medicine |
| Location | 445 30th St, Oakland, California |
| Authorized Official Name and Position | Bruce P Lawrence (PRESIDENT) |
| Authorized Official Contact | 5104652500 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bruce Lawrence Md Prof Corp 445 30th St 2nd Floor Oakland CA 94609-3301 Ph: () - | Bruce Lawrence Md Prof Corp 445 30th St 2nd Floor Oakland CA 94609-3301 Ph: (510) 465-2500 |
| NPI Number | 1871685255 |
|---|---|
| Provider Enumeration Date | 09/29/2006 |
| Last Update Date | 05/29/2015 |
| Medicare PECOS PAC ID | 2668667353 |
|---|---|
| Medicare Enrollment ID | O20101108000725 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871685255 | NPI | - | NPPES |
| 00G247360 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207QA0505X | Family Medicine - Adult Medicine | G24736 (California) | Primary |
| Provider Name | Bruce Lawrence |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1710901616 PECOS PAC ID: 2466647151 Enrollment ID: I20101108000755 |
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