Robert J. Lavaysse, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

G58295 Issued in CA

Practice address

97 San Marin Dr
Novato, CA 94945-1100

Phone

(415) 899-7400

NPI assigned

Oct 25, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1093899072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 HARRISON ST FL 7",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946123429",
            "telephone_number": "510-625-6262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "97 SAN MARIN DR",
            "city": "NOVATO",
            "state": "CA",
            "postal_code": "949451100",
            "telephone_number": "415-899-7400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAVAYSSE",
        "first_name": "ROBERT",
        "middle_name": "J.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "G58295",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G582950",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mark Larroque, P.A.
• Tara Lasheen, LCSW
• Gayle Ym Lau, PHARM.D
• Tiffany Ya Ming Lau, OD
• Laura Darby, M.D., PC
• Mark S Lawler, MD
• Ngoc Anh Le, RDH
• Keyanna Rene Learson
• Eden Rose Lebold
• Jordan Baer Lebsock

• Internal Medicine Physician in Novato, CA
• Providers in Novato, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.