Laurence J Mazzotta, M.D.

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

G28907 Issued in CA

Practice address

480 Redwood St.
Ste. 14
Vallejo, CA 94590-2958

Phone

(707) 648-3327

Fax

(707) 648-3902

NPI assigned

Apr 17, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

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

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.

• Laurence J. Mazzotta MD PC

  • Gastroenterology Physician
  • Vallejo, CA
  • NPI 1386825750
  NPD (past) Authorized official

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

{
    "created_epoch": "1145232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277164800000",
    "number": "1790740546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "480 REDWOOD ST.",
            "address_2": "STE. 14",
            "city": "VALLEJO",
            "state": "CA",
            "postal_code": "945902958",
            "telephone_number": "707-648-3327",
            "fax_number": "707-648-3902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "480 REDWOOD ST.",
            "address_2": "STE. 14",
            "city": "VALLEJO",
            "state": "CA",
            "postal_code": "945902958",
            "telephone_number": "707-648-3327",
            "fax_number": "707-648-3902"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAZZOTTA",
        "first_name": "LAURENCE",
        "middle_name": "J",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-17",
        "last_updated": "2010-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "CA",
            "license": "628907",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "CA",
            "license": "G28907",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G289070",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cheeryl Gene May B Mauricio
• Gev S. Mavandadi, MD
• Eboni Maxwell
• Fernanda Michelle Mayorga, LMFT
• Danielle Mazzei
• Balford McAlpin, CCC-SLP
• Cynthia Loretta McBride, FNP
• Wesley McBride, M.D.
• Sarah B. McCarthy, MD
• Miesha G McCarty

• Gastroenterology Physician in Vallejo, CA
• Providers in Vallejo, CA by specialty
• Gastroenterology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 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.