Provider Demographics
NPI:1285715789
Name:LASHER, MARC D (DO)
Entity type:Individual
Prefix:DR
First Name:MARC
Middle Name:D
Last Name:LASHER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:829 F ST
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93706-3418
Mailing Address - Country:US
Mailing Address - Phone:559-266-0444
Mailing Address - Fax:559-266-7745
Practice Address - Street 1:3707 E SHIELDS AVE
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93726-7029
Practice Address - Country:US
Practice Address - Phone:559-229-9040
Practice Address - Fax:559-229-9060
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-18
Last Update Date:2018-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A7154208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00AX71540Medicaid
CA20A7154OtherD.O.
020A71540Medicare ID - Type Unspecified