Provider Demographics
NPI:1962525279
Name:HOPP, LAWRENCE MICHAEL
Entity type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:MICHAEL
Last Name:HOPP
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8641 WILSHIRE BLVD
Mailing Address - Street 2:SUITE 312
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90211-2900
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8641 WILSHIRE BLVD
Practice Address - Street 2:SUITE 312
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90211-2900
Practice Address - Country:US
Practice Address - Phone:310-275-7848
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG76028207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G760280OtherMEDICAL NUMBER
CAG76028Medicare ID - Type Unspecified
CAF34167Medicare UPIN