Provider Demographics
NPI:1366556797
Name:DAVID A LAUB MD, A PROFESSIONAL CORPORATION
Entity type:Organization
Organization Name:DAVID A LAUB MD, A PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL BILLER
Authorized Official - Prefix:MRS
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:E
Authorized Official - Last Name:FINLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:707-869-2681
Mailing Address - Street 1:591 REDWOOD HWY
Mailing Address - Street 2:SUITE 2210
Mailing Address - City:MILL VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:94941-6003
Mailing Address - Country:US
Mailing Address - Phone:415-381-6661
Mailing Address - Fax:415-789-9882
Practice Address - Street 1:591 REDWOOD HWY
Practice Address - Street 2:SUITE 2210
Practice Address - City:MILL VALLEY
Practice Address - State:CA
Practice Address - Zip Code:94941-6003
Practice Address - Country:US
Practice Address - Phone:415-381-6661
Practice Address - Fax:415-381-6695
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-19
Last Update Date:2008-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG58416207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA53403Medicare UPIN