Michael J Lazar Jr., MD

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

C40958 Issued in CA

Practice address

1140 Sonoma Ave
Ste 1a
Santa Rosa, CA 95405-4817

Phone

(707) 546-5553

Fax

(707) 546-0725

NPI assigned

Apr 5, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Michael J. Lazar, Jr., M.D., Professional Medical Corporation

  • Urology Physician
  • Santa Rosa, CA
  • NPI 1912910811
  NPD (past) Authorized official

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

{
    "created_epoch": "1144195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1328572800000",
    "number": "1376505180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3536 MENDOCINO AVE",
            "address_2": "STE 200",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954033634",
            "telephone_number": "707-575-6049",
            "fax_number": "707-546-0725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1140 SONOMA AVE",
            "address_2": "STE 1A",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954054817",
            "telephone_number": "707-546-5553",
            "fax_number": "707-546-0725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAZAR",
        "first_name": "MICHAEL",
        "middle_name": "J",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-05",
        "last_updated": "2012-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "CA",
            "license": "C40958",
            "primary": true
        },
        {
            "code": "2088P0231X",
            "taxonomy_group": "",
            "desc": "Urology, Pediatric Urology",
            "state": "CA",
            "license": "C40958",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00638732",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1376505180",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BS OF CALIFORNIA",
            "identifier": "00C409580",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Madeline Mackenzie Lawrence
• Pauline Frances Lawrence, RPH
• Valeria Lawrence, DDS
• Deborah D. Lawson, MD
• Michael Wayne Lawson, D.C.
• Gerry V. Lazzareschi, MD
• LCS Santa Rosa LLC
• Amy C Le, PHARM. D.
• Danny Chen Le, O.D.
• Nicole N Le, DDS

• Urology Physician in Santa Rosa, CA
• Providers in Santa Rosa, CA by specialty
• Urology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2012; 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.