Provider Demographics
NPI:1316992068
Name:HIGHMAN, LAWRENCE M (MD)
Entity type:Individual
Prefix:
First Name:LAWRENCE
Middle Name:M
Last Name:HIGHMAN
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 1:101 3RD ST
Mailing Address - Street 2:
Mailing Address - City:COLUSA
Mailing Address - State:CA
Mailing Address - Zip Code:95932-2700
Mailing Address - Country:US
Mailing Address - Phone:530-458-7778
Mailing Address - Fax:530-458-7013
Practice Address - Street 1:155 E WEBSTER ST
Practice Address - Street 2:
Practice Address - City:COLUSA
Practice Address - State:CA
Practice Address - Zip Code:95932
Practice Address - Country:US
Practice Address - Phone:530-458-7778
Practice Address - Fax:530-458-7013
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-23
Last Update Date:2016-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG40201208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA222959182Medicare ID - Type Unspecified
A48135Medicare UPIN