Provider Demographics
NPI:1194876748
Name:LAMBROS, VAL II (MD)
Entity type:Individual
Prefix:DR
First Name:VAL
Middle Name:
Last Name:LAMBROS
Suffix:II
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 1:360 SAN MIGUEL DR STE 406
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-7822
Mailing Address - Country:US
Mailing Address - Phone:949-759-4733
Mailing Address - Fax:949-759-5458
Practice Address - Street 1:360 SAN MIGUEL DR STE 406
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-7822
Practice Address - Country:US
Practice Address - Phone:949-759-4733
Practice Address - Fax:949-759-5458
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG30718174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA91304Medicare UPIN