| Lowell P Theard Md Inc | |
|
3831 Hughes Ave 705 Culver City CA 90232-2751 | |
| (310) 838-6801 | |
| (310) 838-5385 |
| Full Name | Lowell P Theard Md Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 3831 Hughes Ave, Culver City, California |
| Authorized Official Name and Position | Lowell P Theard (PRESIDENT) |
| Authorized Official Contact | 3108386801 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lowell P Theard Md Inc 4206 Don Tapia Pl Los Angeles CA 90008-4236 Ph: (310) 838-6801 | Lowell P Theard Md Inc 3831 Hughes Ave 705 Culver City CA 90232-2751 Ph: (310) 838-6801 |
| NPI Number | 1023065992 |
|---|---|
| Provider Enumeration Date | 05/27/2006 |
| Last Update Date | 09/27/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023065992 | NPI | - | NPPES |
| 1023065992 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | G37108 (California) | Primary |
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