Individual provider Active NPI

Lance Robert Dursi, RDMS

  • Clinical Medical Laboratory
  • Los Gatos, CA
National Provider Identifier
1780909804
Registry record updated Mar 31, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
License
10468 Issued in CA
Practice address
15899 Los Gatos Almaden Rd Ste 6
Los Gatos, CA 95032-3739
Phone
(408) 356-0004
Fax
(408) 356-8735
NPI assigned
Mar 31, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 31, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X 10468 CA Primary

Addresses

Primary practice location

15899 Los Gatos Almaden Rd Ste 6
Los Gatos, CA 95032-3739

Mailing address

15899 Los Gatos Almaden Rd Ste 6
Los Gatos, CA 95032-3739
Phone (408) 356-0004

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

LicenseStateTypeSpecialty
10468CAMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1269993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1269993600000",
    "number": "1780909804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15899 LOS GATOS ALMADEN RD STE 6",
            "city": "LOS GATOS",
            "state": "CA",
            "postal_code": "950323739",
            "telephone_number": "408-356-0004",
            "fax_number": "408-356-8735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15899 LOS GATOS ALMADEN RD STE 6",
            "city": "LOS GATOS",
            "state": "CA",
            "postal_code": "950323739",
            "telephone_number": "408-356-0004",
            "fax_number": "408-356-8735"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DURSI",
        "first_name": "LANCE",
        "middle_name": "ROBERT",
        "name_prefix": "Mr.",
        "credential": "RDMS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-03-31",
        "last_updated": "2010-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "CA",
            "license": "10468",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Gatos, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2010; 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.