Provider Demographics
NPI:1912923913
Name:SHER, LAWRENCE DAVID (MD)
Entity type:Individual
Prefix:
First Name:LAWRENCE
Middle Name:DAVID
Last Name:SHER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 4019
Mailing Address - Street 2:
Mailing Address - City:ROLLING HILLS ESTATES
Mailing Address - State:CA
Mailing Address - Zip Code:90274-9552
Mailing Address - Country:US
Mailing Address - Phone:310-544-6858
Mailing Address - Fax:310-544-6855
Practice Address - Street 1:501 DEEP VALLEY DR
Practice Address - Street 2:SUITE 210
Practice Address - City:ROLLING HILLS ESTATES
Practice Address - State:CA
Practice Address - Zip Code:90274-7605
Practice Address - Country:US
Practice Address - Phone:310-544-6858
Practice Address - Fax:310-544-6855
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-14
Last Update Date:2022-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG52657207KA0200X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergy
Not Answered208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
WG52657COtherPPIN
B57944Medicare UPIN