Provider Demographics
NPI:1871595660
Name:SERIF, LAWRENCE W (DO)
Entity type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:W
Last Name:SERIF
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 446
Mailing Address - Street 2:
Mailing Address - City:RANCHO MIRAGE
Mailing Address - State:CA
Mailing Address - Zip Code:92270
Mailing Address - Country:US
Mailing Address - Phone:760-285-3216
Mailing Address - Fax:760-416-4512
Practice Address - Street 1:1180 N INDIAN CANYON DR
Practice Address - Street 2:SUITE W-201
Practice Address - City:PALM SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:92262-4800
Practice Address - Country:US
Practice Address - Phone:760-416-4511
Practice Address - Fax:760-416-4512
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-11
Last Update Date:2015-07-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA20A8804207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA020A88040Medicare ID - Type Unspecified
CAE69197Medicare UPIN