Basic Information
Provider Information
NPI: 1912575630
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: LACAR
FirstName: LAURENCE LEA
MiddleName: MALLARI
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1319 PUNAHOU ST STE 824
Address2:  
City: HONOLULU
State: HI
PostalCode: 968261032
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 1319 PUNAHOU ST STE 824
Address2:  
City: HONOLULU
State: HI
PostalCode: 968261032
CountryCode: US
TelephoneNumber: 8082036518
FaxNumber:  
Other Information
ProviderEnumerationDate: 06/17/2021
LastUpdateDate: 06/17/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 06/16/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207V00000XMDR-8067HIY Allopathic & Osteopathic PhysiciansObstetrics & Gynecology 

No ID Information.


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