Lowell P Theard MD INC
Internal Medicine in Culver City, CA. Organization (NPI-2).
NPI number1023065992
StatusActive
Last updated in NPPESSep 27, 2013
Details
- NPI
- 1023065992
- Entity type
- Organization (NPI-2)
- Legal business name
- Lowell P Theard MD INC
- Organization subpart
- No
- Enumeration date
- May 27, 2006
- Last updated
- Sep 27, 2013
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207R00000X | Internal Medicine | G37108 | CA | Yes |
Practice location
3831 Hughes Ave705
Culver City, CA 90232-2751
Phone 310-838-6801 · Fax 310-838-5385
Mailing address
4206 Don Tapia PlLos Angeles, CA 90008-4236
Phone 310-838-6801 · Fax 310-838-5385
Authorized official
Lowell P Theard
President
3108386801
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