Active NPI
Gino C Lazaro, DIRECTOR OF NURSING
- Registered Nurse
- Harbor City, CA
National Provider Identifier
1083130389
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 552043
- Practice address
- 23331 Maltby PL
Harbor City, CA 90710-1134 - Phone
- (310) 486-5106
- Fax
- (424) 263-4750
- NPI assigned
- Aug 17, 2017
- Last updated
- Jul 21, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 552043 | CA | Primary |
Addresses
Primary practice location
23331 Maltby PL
Harbor City, CA 90710-1134
Mailing address
23331 Maltby PL
Harbor City, CA 90710
Phone (310) 486-5106
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 552043 | CA | MD | Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| CB Carehome, Inc | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1502928000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1083130389",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "23331 MALTBY PL",
"city": "HARBOR CITY",
"state": "CA",
"postal_code": "90710",
"telephone_number": "310-486-5106",
"fax_number": "424-263-4750"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "23331 MALTBY PL",
"city": "HARBOR CITY",
"state": "CA",
"postal_code": "907101134",
"telephone_number": "310-486-5106",
"fax_number": "424-263-4750"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LAZARO",
"first_name": "GINO",
"middle_name": "C",
"name_prefix": "Mr.",
"credential": "DIRECTOR OF NURSING",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-08-17",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "CA",
"license": "552043",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Harbor City, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.