Marc a. Lazzara D.O., a Medical Corporation

Primary specialty

Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X

License

20A7964 Issued in CA

Legal business name

MARC A. LAZZARA D.O., A MEDICAL CORPORATION

Practice address

4521 Charleville Cir
Irvine, CA 92604-2329

Phone

(714) 544-8167

Fax

(949) 679-1909

NPI assigned

Sep 21, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Marc Adam Lazzara, D.O.

Title

Ceo

Phone

(714) 544-8167

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1228435200000",
    "number": "1285733949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4521 CHARLEVILLE CIR",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926042329",
            "telephone_number": "714-544-8167",
            "fax_number": "949-679-1909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4521 CHARLEVILLE CIR",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926042329",
            "telephone_number": "714-544-8167",
            "fax_number": "949-679-1909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARC A. LAZZARA D.O., A MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-21",
        "last_updated": "2008-12-05",
        "status": "A",
        "authorized_official_last_name": "LAZZARA",
        "authorized_official_first_name": "MARC",
        "authorized_official_middle_name": "ADAM",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "714-544-8167",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine, Sports Medicine",
            "state": "CA",
            "license": "20A7964",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lizbeth Manzo-Gonzalez
• David Patrick Mappes
• Mark Mapstone, PHD
• Delilah Mar
• Maria Marasigan
• Marc Pana Professional Dental Corporation
• Rosalinda Marchan
• Nolan Marcos
• Christine Alyse Marcucci, AGPCNP-BC
• Meagan Marie Marcuccilli, M.D.

• Sports Medicine (Family Medicine) Physician in Irvine, CA
• Providers in Irvine, CA by specialty
• Sports Medicine (Family Medicine) Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2008; 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.