Provider Demographics
NPI:1124131446
Name:PIRO, LAWRENCE D (MD)
Entity type:Individual
Prefix:
First Name:LAWRENCE
Middle Name:D
Last Name:PIRO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2001 SANTA MONICA BLVD
Mailing Address - Street 2:SUITE 560W
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90404-2102
Mailing Address - Country:US
Mailing Address - Phone:310-582-7900
Mailing Address - Fax:310-582-7946
Practice Address - Street 1:11800 WILSHIRE BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90025-6602
Practice Address - Country:US
Practice Address - Phone:310-231-2121
Practice Address - Fax:310-231-2199
Is Sole Proprietor?:No
Enumeration Date:2006-08-17
Last Update Date:2024-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG52155207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW15185OtherMEDICARE PTAN - FACILITY
CAG52155OtherMEDICAL LICENSE
CAW15185AOtherMEDICARE PTAN - FACILITY
CAG52155OtherMEDICAL LICENSE
CAW15185AOtherMEDICARE PTAN - FACILITY
CAW15185AOtherMEDICARE PTAN - FACILITY
CAWG52155IMedicare ID - Type Unspecified
CAWG52155JMedicare PIN