| Laurence J. Mazzotta Md Pc | |
|
480 Redwood St Suite 14 Vallejo CA 94590-2958 | |
| (707) 648-3327 | |
| (707) 648-3902 |
| Full Name | Laurence J. Mazzotta Md Pc |
|---|---|
| Speciality | Internal Medicine - Gastroenterology |
| Location | 480 Redwood St, Vallejo, California |
| Authorized Official Name and Position | Laurence J Mazzotta (SOLE PROPRIETOR) |
| Authorized Official Contact | 7076483327 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Laurence J. Mazzotta Md Pc 480 Redwood St Suite 14 Vallejo CA 94590-2958 Ph: (707) 648-3327 | Laurence J. Mazzotta Md Pc 480 Redwood St Suite 14 Vallejo CA 94590-2958 Ph: (707) 648-3327 |
| NPI Number | 1386825750 |
|---|---|
| Provider Enumeration Date | 11/14/2007 |
| Last Update Date | 10/06/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386825750 | NPI | - | NPPES |
| 00G289070 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | G28907 (California) | Primary |
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