Lawrence Gordon Foster, M.D.
Individual provider Active NPI Surgery Physician · Anza, CA
NPI 1629094339 · NPPES record last updated May 26, 2015
Key facts
- NPI
- 1629094339
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Surgery Physician 208600000X
- License
- A34957 (CA)
- Practice address
- 58581 US Highway 371
Ste F, G, H
Anza, CA 92539-9331 - Phone
- (951) 763-4759
- NPI assigned
- Jul 14, 2006
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A34957 | CA | MD | Surgery Physician |
| 35.042130 | OH | MD | Surgery Physician |
| 2534A | WY | MD | Surgery Physician |
| 34957 | CA | MD | Technician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | A34957 | CA | Yes |
| Surgery Physician | 208600000X | 35.042130 | OH | |
| Surgery Physician | 208600000X | 2534A | WY |
Addresses
Primary practice location
58581 US Highway 371
Ste F, G, H
Anza, CA 92539-9331
Mailing address
230 Hospital Dr Ste B
Ukiah, CA 95482-4563
Phone (707) 463-3501
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0A349570 | Medicaid | CA |
Other providers in Anza, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 26, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.