| Lauri I An Md A Medical Corporation | |
|
2655 W Olympic Blvd Ste 207 Los Angeles CA 90006-2800 | |
| (213) 388-7887 | |
| Not Available |
| Full Name | Lauri I An Md A Medical Corporation |
|---|---|
| Speciality | Family Medicine |
| Location | 2655 W Olympic Blvd Ste 207, Los Angeles, California |
| Authorized Official Name and Position | Lauri An (PRESIDENT/MD) |
| Authorized Official Contact | 2133887887 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lauri I An Md A Medical Corporation 2655 W Olympic Blvd Ste 207 Los Angeles CA 90006-2800 Ph: (213) 388-7887 | Lauri I An Md A Medical Corporation 2655 W Olympic Blvd Ste 207 Los Angeles CA 90006-2800 Ph: (213) 388-7887 |
| NPI Number | 1164006714 |
|---|---|
| Provider Enumeration Date | 05/10/2021 |
| Last Update Date | 05/10/2021 |
| Medicare PECOS PAC ID | 7113326687 |
|---|---|
| Medicare Enrollment ID | O20210603001402 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164006714 | NPI | - | NPPES |
| A42565 | Other | CA | LIC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Lauri I An |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1134168891 PECOS PAC ID: 4183664279 Enrollment ID: I20050509000352 |
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