Lowell P Theard Md Inc | |
3831 Hughes Ave 705 Culver City CA 90232-2751 | |
(310) 838-6801 | |
(310) 838-5385 |
Full Name | Lowell P Theard Md Inc |
---|---|
Speciality | Internal Medicine |
Location | 3831 Hughes Ave, Culver City, California |
Authorized Official Name and Position | Lowell P Theard (PRESIDENT) |
Authorized Official Contact | 3108386801 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Lowell P Theard Md Inc 4206 Don Tapia Pl Los Angeles CA 90008-4236 Ph: (310) 838-6801 | Lowell P Theard Md Inc 3831 Hughes Ave 705 Culver City CA 90232-2751 Ph: (310) 838-6801 |
NPI Number | 1023065992 |
---|---|
Provider Enumeration Date | 05/27/2006 |
Last Update Date | 09/27/2013 |
Identifier | Type | State | Issuer |
---|---|---|---|
1023065992 | NPI | - | NPPES |
1023065992 | Medicaid | CA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | G37108 (California) | Primary |
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