David Lazar M.D., a Medical Corp

Primary specialty

Retina Specialist (Ophthalmology) PhysicianTaxonomy code 207WX0107X

Legal business name

DAVID LAZAR M.D., A MEDICAL CORP

Practice address

12301 Wilshire Blvd # 420
Los Angeles, CA 90025-1007

Phone

(866) 773-8462

Fax

(818) 659-7695

NPI assigned

Mar 15, 2019

Organization subpart

No

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

Authorized official

Name

David B. Lazar, MDNPI 1417242975

Title

Owner

Phone

(866) 773-8462

Specialties & licenses 1

Addresses

Other names 1

• David Lazar, M.D. Medical Coproration Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• David B. Lazar, M.D.

  • Retina Specialist (Ophthalmology) Physician
  • Los Angeles, CA
  • NPI 1417242975
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1552608000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724976000000",
    "number": "1922567387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12301 WILSHIRE BLVD STE 420",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900251007",
            "telephone_number": "866-773-8462",
            "fax_number": "818-659-7695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12301 WILSHIRE BLVD # 420",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900251007",
            "telephone_number": "866-773-8462",
            "fax_number": "818-659-7695"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11600 Wilshire Blvd Ste 522",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900251788",
            "country_code": "US",
            "telephone_number": "866-773-8462",
            "fax_number": "818-659-7695",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "DAVID LAZAR M.D., A MEDICAL CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-15",
        "last_updated": "2024-08-30",
        "certification_date": "2024-08-30",
        "status": "A",
        "authorized_official_last_name": "LAZAR",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "B.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "866-773-8462",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207WX0107X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology, Retina Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "David Lazar, M.D. Medical Coproration",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "David Lazar, M.D. Medical Coproration",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Retina Specialist (Ophthalmology) Physician in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Retina Specialist (Ophthalmology) Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.