| Marc A. Lazzara D.o., A Medical Corporation | |
|
4521 Charleville Cir Irvine CA 92604-2329 | |
| (714) 544-8167 | |
| (949) 679-1909 |
| Full Name | Marc A. Lazzara D.o., A Medical Corporation |
|---|---|
| Speciality | Family Medicine - Sports Medicine |
| Location | 4521 Charleville Cir, Irvine, California |
| Authorized Official Name and Position | Marc Adam Lazzara (CEO) |
| Authorized Official Contact | 7145448167 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Marc A. Lazzara D.o., A Medical Corporation 4521 Charleville Cir Irvine CA 92604-2329 Ph: (714) 544-8167 | Marc A. Lazzara D.o., A Medical Corporation 4521 Charleville Cir Irvine CA 92604-2329 Ph: (714) 544-8167 |
| NPI Number | 1285733949 |
|---|---|
| Provider Enumeration Date | 09/21/2006 |
| Last Update Date | 12/05/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285733949 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207QS0010X | Family Medicine - Sports Medicine | 20A7964 (California) | Primary |
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