| Edward P. Laurance, M.d., Inc | |
|
460 W Sierra Madre Blvd Sierra Madre CA 91024-2314 | |
| (626) 836-6900 | |
| Not Available |
| Full Name | Edward P. Laurance, M.d., Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 460 W Sierra Madre Blvd, Sierra Madre, California |
| Authorized Official Name and Position | Kimberly Ann Bibb (OFFICE MANAGER) |
| Authorized Official Contact | 6268366900 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Edward P. Laurance, M.d., Inc 460 W Sierra Madre Blvd Sierra Madre CA 91024-2314 Ph: (626) 836-6900 | Edward P. Laurance, M.d., Inc 460 W Sierra Madre Blvd Sierra Madre CA 91024-2314 Ph: (626) 836-6900 |
| NPI Number | 1225422033 |
|---|---|
| Provider Enumeration Date | 03/19/2015 |
| Last Update Date | 03/19/2015 |
| Medicare PECOS PAC ID | 9234543109 |
|---|---|
| Medicare Enrollment ID | O20210204001820 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225422033 | NPI | - | NPPES |
| 17980780799 01 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | (* (Not Available)) | Primary |
| Provider Name | Edward Laurance |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1790780799 PECOS PAC ID: 4880742147 Enrollment ID: I20090427000162 |
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